TY - JOUR
T1 - Reassessment of non-Hodgkin's lymphoma with a 'nodular' growth variant
T2 - A clinicopathologic study of follicular, mantle cell and marginal zone lymphomas prospectively diagnosed with multiparameter analyses
AU - Kadowaki, Ikuko
AU - Ichinohasama, Ryo
AU - Sasaki, Osamu
AU - Kimura, Jun
AU - Kameoka, Jun Ichi
AU - Meguro, Kuniaki
AU - Endo, Kazuyasu
AU - Tobinai, Kensei
AU - Sasaki, Takeshi
AU - Sawai, Takashi
AU - Ooya, Kiyoshi
N1 - Funding Information:
We are grateful to (listed alphabetically) Dr. Toshi-kazu Awataguchi (Tohoku Welfare Pension Hospital), Dr Kyoko Kaneda (Miyagi National Hospital), Dr. Syunichi Kato (Sendai City Medical Center, Sendai Open Hospital), Dr. Mari Komatsu (Katta General Hospital), Dr. Yasushi Mitachi (Sendai Kosei Hospital), Dr. Yukio Sekiguchi (NTT Tohoku Hospital), Dr. Isao Sat0 (National Sendai Hospital), Dr. Tomohiro Sugawara (Furukawa City Hospital), Dr. Norimichi Watanabe (Suifu Hospital), Dr. Hironao Yokomichi (Hanamaki General Hospital), Dr. Yutaka Horino (Iwadeyama Hospital), Dr. Atsushi Oosato (Oosato's office), Dr. Fumio Arizi (Sennan Hospital), Dr. Hideo Harigae (Suifu Hospital), Dr. Osamu Fukuhara (Miyagino Hospital), Dr Katsuaki Kato (Third Department of Internal Medicine, Tohoku University School of Medicine), Dr. Motonobu Osada (Institute of Development, Aging and Cancer, Tohoku University) for their help. Grant support and presentation This study was supported in part by a research grant from the Gonryo Medical Foundation, and presented at the Workshop of the 37th Congress of Japanese Association of Clinical Hematology, in November 13-15 in 1996, held in Ohmiya, Japan.
PY - 1998
Y1 - 1998
N2 - Although three subtypes of non-Hodgkin's lymphoma (NHL), follicular lymphoma (FL), mantle cell lymphoma (MCL) and marginal zone lymphoma (MZL), are now well recognized as independent categories, their biological behavior has not been fully compared. One of the reasons for this may be that subclassification by histological examination alone is often difficult since they all have a common variant of a 'nodular' growth pattern and occasionally show similar cytological morphology. Recently, we reviewed patients with FL, MCL and MZL, who were prospectively diagnosed, using multiparameter analyses with unfixed fresh biopsy materials. Of 407 NHL patients, 101 (24.8%) belonged to these three categories and 80 could be followed; FL (n = 27), MCL (n = 27) and MZL (n = 26). Twenty eight cases with diffuse large B-cell (DL-B) lineage lymphoma were selected as control at random. The frequency of the MCL patients with performance status (PS) 2 to 4 (41%) was significantly higher than MZL patients (4%) [P < 0.001]. The 3 year survival rate with FL, MCL, MZL and DL-B was 71.5%, 57.4%, 93.3% and 53.1%, respectively. The survival rate for MZL was significantly better than both FL (p = 0.048) and MCL (p = 0.0085). Significant differences were also found in the overall survival rates among the four risk groups as defined by the International Index [I2](low, low-intermediate, high-intermediate and high; 97.4%, 79.6%, 39.4% and 18.2%, respectively). A multivariate analysis revealed that the International Index may be a significant predictor for short survival (p = 0.0001) in the patients with FL, MCL or MZL. These results suggest that MZL shows an apparently better prognosis than FL and MCL and is found to be a prognostically independent category. In contrast, the clinical outcome in MCL is the worst among the three subtypes and was closer to that of DL-B. The International Index can be applied to a wide spectrum of NHL, including MCL, MZL and FL, to and can predict prognosis in these cases.
AB - Although three subtypes of non-Hodgkin's lymphoma (NHL), follicular lymphoma (FL), mantle cell lymphoma (MCL) and marginal zone lymphoma (MZL), are now well recognized as independent categories, their biological behavior has not been fully compared. One of the reasons for this may be that subclassification by histological examination alone is often difficult since they all have a common variant of a 'nodular' growth pattern and occasionally show similar cytological morphology. Recently, we reviewed patients with FL, MCL and MZL, who were prospectively diagnosed, using multiparameter analyses with unfixed fresh biopsy materials. Of 407 NHL patients, 101 (24.8%) belonged to these three categories and 80 could be followed; FL (n = 27), MCL (n = 27) and MZL (n = 26). Twenty eight cases with diffuse large B-cell (DL-B) lineage lymphoma were selected as control at random. The frequency of the MCL patients with performance status (PS) 2 to 4 (41%) was significantly higher than MZL patients (4%) [P < 0.001]. The 3 year survival rate with FL, MCL, MZL and DL-B was 71.5%, 57.4%, 93.3% and 53.1%, respectively. The survival rate for MZL was significantly better than both FL (p = 0.048) and MCL (p = 0.0085). Significant differences were also found in the overall survival rates among the four risk groups as defined by the International Index [I2](low, low-intermediate, high-intermediate and high; 97.4%, 79.6%, 39.4% and 18.2%, respectively). A multivariate analysis revealed that the International Index may be a significant predictor for short survival (p = 0.0001) in the patients with FL, MCL or MZL. These results suggest that MZL shows an apparently better prognosis than FL and MCL and is found to be a prognostically independent category. In contrast, the clinical outcome in MCL is the worst among the three subtypes and was closer to that of DL-B. The International Index can be applied to a wide spectrum of NHL, including MCL, MZL and FL, to and can predict prognosis in these cases.
KW - Follicular lymphoma
KW - International Index
KW - Mantle cell lymphoma
KW - Marginal zone lymphoma
KW - Multiparameter analysis
KW - Non-Hodgkin's lymphoma
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U2 - 10.3109/10428199809059233
DO - 10.3109/10428199809059233
M3 - Article
C2 - 9869204
AN - SCOPUS:0032217306
VL - 31
SP - 393
EP - 403
JO - Leukemia and Lymphoma
JF - Leukemia and Lymphoma
SN - 1042-8194
IS - 3-4
ER -