LARGE-CELL LYMPHOMAS - CLINICAL AND PROGNOSTIC FEATURES

被引:30
|
作者
STEIN, RS [1 ]
GREER, JP [1 ]
FLEXNER, JM [1 ]
HAINSWORTH, JD [1 ]
COLLINS, RD [1 ]
MACON, WR [1 ]
COUSAR, JB [1 ]
机构
[1] VANDERBILT UNIV,MED CTR,DEPT PATHOL,NASHVILLE,TN 37232
关键词
D O I
10.1200/JCO.1990.8.8.1370
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
We reviewed the clinical and pathologic features in 186 patients with large-cell lymphomas seen at Vanderbilt University Hospital between 1970 and 1986. Ninety-two cases (49%) were large noncleaved-cell lymphoma (LNCCL), 61 cases (33%) were large-cleaved-cell lymphoma (LCCL), 17 cases (9%) were peripheral T-cell lymphoma (PTCL), and 16 cases (9%) were immunoblastic sarcoma of B cells (IBS-B). These subsets of large-cell lymphoma did not differ with respect to median age, distribution by stage, or incidence of bone marrow involvement. Significant differences between groups were noted with regard to male:female ratio, incidence of symptoms, incidence of extranodal disease, and pattern of adenopathy. However, when LCCL was excluded from the analysis, none of these differences were significant. By univariate analysis, age, stage, marrow involvement, extranodal disease, B symptoms, elevated serum lactic dehydrogenase (LDH), and diffuse pattern were unfavorable prognostic features in large-cell lymphoma. However, when cases were stratified by cell of origin, nodular versus diffuse pattern was of no prognostic significance. Modularity was favorable only because 71% of nodular and nodular-diffuse cases were LCCL, while the majority of diffuse cases were LNCCL. Although IBS-B is considered a "high-grade" lymphoma, we found no evidence for inferior survival in these patients compared with LNCCL or LCCL. In fact, survival was better in IBS-B than in LNCCL or LCCL, although this difference was not significant. However, survival was significantly inferior in PTCL (median, 11 months) compared with the other subsets of large-cell lymphoma (median, 46 months; P = .038, log-rank test). Since the association of PTCL and an inferior survival has most often been noted in the context of "second-generation" chemotherapy, we believe that this association may be therapy-dependent and may be minimized by the use of more aggressive chemotherapy regimens.
引用
收藏
页码:1370 / 1379
页数:10
相关论文
共 50 条
  • [31] ANAPLASTIC LARGE-CELL KI-1 MALIGNANT-LYMPHOMAS - RECOGNITION, BIOLOGICAL AND CLINICAL IMPLICATIONS
    KINNEY, MC
    GREER, JP
    GLICK, AD
    SALHANY, KE
    COLLINS, RD
    PATHOLOGY ANNUAL, 1991, 26 : 1 - 24
  • [32] RELATIONSHIP BETWEEN NUCLEAR MORPHOLOGY AND DNA CONTENT IN LARGE-CELL LYMPHOMAS
    BILLIET, J
    CRIEL, A
    VANVUCHELEN, J
    HIDAJAT, M
    VANHOOF, A
    LOUWAGIE, A
    MICHIELSSEN, P
    ANALYTICAL AND QUANTITATIVE CYTOLOGY AND HISTOLOGY, 1994, 16 (05): : 339 - 344
  • [33] PROGNOSTIC INDICATORS IN DIFFUSE LARGE-CELL (HISTIOCYTIC) LYMPHOMA
    TODD, MB
    PORTLOCK, CS
    FARBER, LR
    HOLFORD, TR
    BERTINO, JR
    INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 1986, 12 (04): : 593 - 601
  • [34] LARGE-CELL LYMPHOMAS OF THE SKIN - A CLINICOPATHOLOGICAL AND IMMUNOHISTOLOGICAL STUDY OF 13 CASES
    SMOLLE, J
    ORTNER, R
    KERL, H
    AMERICAN JOURNAL OF DERMATOPATHOLOGY, 1987, 9 (02) : 166 - 166
  • [35] Large-cell neuroendocrine carcinoma of the kidney: Clinicopathologic features
    Ratnagiri, Ranganath
    Singh, Shirley Sunder
    Majhi, Urmila
    Kathiresan
    Sateeshan
    INDIAN JOURNAL OF UROLOGY, 2009, 25 (02) : 274 - 275
  • [36] EXPRESSION OF CD44 SPLICE VARIANTS IN INFREQUENT IN LARGE-CELL LYMPHOMAS (INCLUDING ANAPLASTIC LARGE-CELL) AND HODGKINS-DISEASE
    MASUDA, Y
    INGHIRAMI, G
    FRIZZERA, G
    LABORATORY INVESTIGATION, 1995, 72 (01) : A116 - A116
  • [37] PREDICTIVE VALUE OF THE INTERNATIONAL PROGNOSTIC INDEX IN NON-HODGKINS-LYMPHOMA SUBTYPES OTHER THAN LARGE-CELL LYMPHOMAS
    ROGGERO, E
    ZUCCA, E
    PINOTTI, G
    BERNASCONI, A
    DEVECCHIS, L
    CAVALLI, F
    BLOOD, 1994, 84 (10) : A157 - A157
  • [38] Autologous stem cell transplantation for anaplastic large-cell lymphomas: results of a prospective trial
    Deconinck, E
    Lamy, T
    Foussard, C
    Gaillard, F
    Delwail, V
    Colombat, P
    Casassus, P
    Lemevel, A
    Brion, A
    Milpied, N
    BRITISH JOURNAL OF HAEMATOLOGY, 2000, 109 (04) : 736 - 742
  • [39] BCL6 REARRANGEMENT DEFINES A CLINICAL AND PROGNOSTIC SUBSET OF DIFFUSE LARGE-CELL LYMPHOMA
    OFFIT, K
    LOCOCO, F
    LOUIE, D
    PARSA, NZ
    YE, BH
    ROSENBAUM, A
    SIEBERT, R
    DALLAFAVERA, R
    CHAGANTI, RSK
    BLOOD, 1993, 82 (10) : A133 - A133
  • [40] CLINICAL-FEATURES OF 31 PATIENTS WITH KI-1 ANAPLASTIC LARGE-CELL LYMPHOMA
    GREER, JP
    KINNEY, MC
    COLLINS, RD
    SALHANY, KE
    WOLFF, SN
    HAINSWORTH, JD
    FLEXNER, JM
    STEIN, RS
    JOURNAL OF CLINICAL ONCOLOGY, 1991, 9 (04) : 539 - 547