Non-hodgkin's lymphoma, poorly differentiated lymphocytic and mixed cell types.Results of sequential staging procedures, response to therapy, and survival of 100 patients

Autor: John E. Ultmann, James E. Vardiman, J. Bruce Miller, Eric P. Lester, Jeannie Kinzie, Jacob D. Bitran, Ann Kinnealey, Donald L. Sweet, Edgar M. Moran, Richard S. Stein, Nina O. Roth, Harvey M. Golomb
Rok vydání: 1978
Předmět:
Zdroj: Cancer. 42:88-95
ISSN: 1097-0142
0008-543X
DOI: 10.1002/1097-0142(197807)42:1<88::aid-cncr2820420115>3.0.co;2-u
Popis: The results of sequential staging procedures including laparotomy, radiotherapy, and combination chemotherapy are reported for 100 patients with poorly differentiated lymphocytic (PDL) and mixed cell (MC) non-Hodgkin's lymphoma (NHL). Twelve patients were found to have localized disease, pathologic stage (PS) I or II; 88 patients had PS III or IV disease. Bone marrow biopsy showed a high incidence of involvement and advanced 34% of the patients from PS I, II, and III to PS IV. Staging laparotomy has a very limited role in the evaluation of these patients. All of 12 patients with PS I and II NHL were treated with radiotherapy; at 5 years, they had 100% survival, 80% being disease-free. Fifteen patients with PS III disease were treated with total nodal radiotherapy (TNRT) alone and had a median disease-free survival of 41 months. The remaining patients with PS III and IV disease were treated with chemotherapy consisting of vincristine and prednisone (V and P); cyclophosphamide, vincristine (Oncovin), procarbazine, and prednisone (COPP); cyclophosphamide, vincristine (Oncovin), adriamycin, and prednisone (COPA); or palliative therapy consisting of chlorambucil and prednisone. Two-year and 4-year survivals for patients with diffuse lymphoma were 93% and 60%, respectively; for patients with +2 nodular lymphoma, 80% andmore » 30%; and for patients with nodular lymphomas, 76 to 93% and 50%, respectively. Treatment with COPP showed no advantage over V and P, palliative therapy, or TNRT for patients with +2 nodular and nodular disease. The likelihood of cure appears most promising for patients in complete remission (CR) with diffuse lymphoma; patients in CR with nodular lymphoma show a high rate of relapse over 5 years of observation. We conclude that staging laparotomy in PDL and MC NHL is of limited value, and that the role of aggressive chemotherapy for patients with +2 nodular and nodular lymphoma needs to be redefined.« less
Databáze: OpenAIRE
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