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C Lindemalm

Publications and source records attributed to C Lindemalm.

29 records · Page 2Linked to original sources
PubMed1985

CHOP vs MEV for the treatment of non-Hodgkin's lymphoma of unfavourable histopathology: a randomized clinical trial.

The Swedish Lymphoma Study Group has compared the results of treatment with a CHOP regimen (cyclophosphamide, adriamycin, vincristine and prednisone) with those of treatment with a MEV regimen (methotrexate, cyclophosphamide and vincristine) in patients suffering from generalized non-Hodgkin's lymphoma (NHL) of unfavourable histopathology in a prospective randomized trial. The complete remission rate for 67 evaluable patients receiving CHOP was higher (61%) than for 74 patients receiving MEV (24%) (P less than 0.001). The relapse rate was 18/41 (44%) in the CHOP group and 11/18 (61%) in the MEV group (difference not significant). At follow-up the number of patients alive in a first complete remission was thus 23/67 in the CHOP group but only 7/74 (9%) in the MEV group. This difference is highly significant (P less than 0.001). However, there is still no significant difference in overall survival between the two treatment groups. This is probably due to the more efficient rescue treatment (mainly CHOP) found in the patients who primarily received MEV than in those who primarily received CHOP. It is concluded that the CHOP regimen is superior to the MEV regimen in NHL patients with unfavourable histopathology.

Adult↗
PubMed1983

Characterization of malignant and non-neoplastic cell phenotypes in highly malignant non-Hodgkin lymphomas.

Malignant and non-neoplastic cells in 38 cases of highly malignant non-Hodgkin lymphomas: 3 centrocytic anaplastic, 18 centroblastic, 13 immunoblastic and 4 lymphoblastic (according to the Kiel classification) were immunophenotyped in cryosections and cell suspensions by means of monoclonal antibodies. Additionally, cell cycle analysis on cell suspensions was performed by DNA flow cytofluorometry. In 33 (87%) lymphomas the malignant cells expressed monoclonal surface immunoglobulin (Ig), which indicated B-cell origin of tumors. In 7 of the 19 B-cell lymphomas tested by the peroxidase-antiperoxidase method, cytoplasmic Ig was found. Four lymphomas were of T-cell and one of non-B/non-T-cell origin. In II B-cell and 2 lymphoblastic non-B-cell tumors, common acute lymphoblastic leukemia antigen (CALLA) was found. In 25 of 30 studied NHL the malignant cells expressed receptor for transferrin and in 19 of 28 cases a high percentage of cells in S-phase (greater than 10.85%) was found. Number and distribution as well as type of non-B-cells infiltrating B-cell-derived lymphomas varied considerably from case to case. Among these cells Leu 3+ (T helper/inducer) cells predominated. Leu 2+ (T suppressor/cytotoxic) and Leu 7+ (natural killer and killer) cells constituted less numerous groups. Correlation of cytodiagnostic analyses with clinical observations indicates that high content of infiltrating T cells may be a favorable prognostic feature in highly malignant B-cell lymphomas.

Adolescent↗
PubMed1983

Epstein-Barr virus-associated antibody pattern in untreated non-Hodgkin lymphoma patients. Relationship to clinical variables and lymphocyte functions.

Sera from 296 unselected and untreated patients with non-Hodgkin lymphoma (NHL) classified according to the Rappaport and the Kiel systems were analyzed for antibodies to Epstein-Barr virus (EBV). The aim of the study was to determine whether antibody spectra and titers to EBV-coded antigens correlated to clinical and immunological variables and whether the titers were of any prognostic significance. Increased antibody titers to EB viral capsid antigen (VCA) and slightly raised titers to early antigens (EA) of the diffuse (D) and restricted (R) types were noted frequently. Anti-VCA antibody titers correlated to clinical stage and age of the patients but not to histological subgroups according to the Rappaport or the Kiel classification systems. However, anti-VCA titers greater than or equal to 1:2560 were seen only in diffuse lymphomas according to the Rappaport and in non-follicle cell-derived lymphomas according to the Kiel classifications. Patients with complement-receptor-positive diffuse lymphomas had higher anti-VCA titers than complement-receptor-positive nodular cases. Anti-VCA titers also correlated positively to serum IgG levels (p less than 0.01). Total number of lymphocytes separated from peripheral blood and mitogen induced (ConA, PWM) DNA synthesis were recorded before treatment in 56 of the patients. The patients exhibited a significant lymphocytopenia as well as a significantly reduced lymphocyte response to mitogens (p less than 0.001) compared to healthy controls. Elevated anti-VCA titers and anti-EA titers correlated to a good mitogen-induced lymphocyte response (p less than 0.05). Only anti-D 1:40 at diagnosis predicted a poor prognosis.

Adolescent↗
PubMed1983

Blood and lymph node T-lymphocyte subsets in non-Hodgkin lymphomas.

Blood and lymph node T-lymphocyte subpopulations have been studied in untreated non-Hodgkin lymphoma (NHL) patients and healthy controls. T-lymphocytes were determined by the E-rosette technique and by OKT3/LEU4 monoclonal antibodies; OKT4/LEU3 and OKT8/LEU2 monoclonal antibodies were used to identify T-cell subsets with helper/inducer and suppressor/cytotoxic activity, respectively. OKT4+ T-cells were low in patients, while OKT8+ T-cell numbers were normal. The OKT4+/OKT8+ blood lymphocyte ratio was below the normal range in about 50% of the patients. The ratio was higher in lymph nodes than in blood of patients and controls. The results may suggest that untreated NHL patients have a reduced pool of T-cells with phenotypic markers of OKT4/LEU3. Monoclonal blood B-lymphocytes were found in 45% of the cases. The presence of such cells in blood was frequently associated with a low OKT4+/OKT8+ ratio.

Aged↗
PubMed1983

Correlation of immunophenotype to morphology in unfavourable non-Hodgkin lymphoma.

The relationship between immunological markers and histology according to the Kiel classification was studied in 40 adult non-Hodgkin lymphoma patients of Rappaport unfavourable histology. The membrane-associated and cytoplasmic Ig as well as receptors for sheep erythrocytes, Fc gamma and C3d receptors were analyzed on cryostate sections and in suspension. In some cases, a more precise immunophenotype was achieved by the use of monoclonal antibodies detecting different T and B cell antigens. Eighty-eight per cent of the lymphomas had B-cell, five per cent T cell and 7 per cent non-B/non-T cell phenotypes. All CBCC and CC lymphomas expressed monotypic Ig, but only 66 per cent of the CB lymphomas. Thus, morphology alone did not consistently predict immunophenotype in large-cell lymphomas. A simultaneous expression of multiple heavy chains and cytoplasmic Ig was found in some lymphomas, suggesting an intratumoral differentiation. The nodular or irregular tissue distribution patterns for Ig and C3d receptors found in histologically diffuse follicle derived lymphomas also suggest intratumoral variations in the marker expression, probably related to differentiation. The results suggest that lymphoma immunophenotype is important in obtaining a definite diagnosis in large-cell lymphomas and that it may lead to a better understanding of the differentiation of lymphomas of low-grade malignancy.

Adult↗
PubMed1983

A clinico-pathological and immunological study of unfavourable non-Hodgkin lymphomas. Comparison of the Rappaport and Kiel classifications.

To evaluate the prognostic information of the Kiel classification a homogeneous material of 63 non-Hodgkin lymphomas of unfavourable Rappaport histology were re-evaluated according to the definitions of the Kiel classification. The patients were selected from a prospective lymphoma study including 775 patients. Only ambiguous histological diagnoses analysed independently by two hematopathologists were accepted. Immunological markers of the tumours studied both in suspensions and on cryostate sections were in addition analysed in 40 of the patients. Forty-one per cent (26/63) were of high grade malignancy according to the Kiel classification, 59% (36/63) were of low-grade malignancy. The DLPD group was most heterogeneous while a better concordance was found between DM and CB/CC and between DH and CB cases. However, prognostic subgroups of the two classifications were only partly equivalent. A good correlation was found between the Kiel high-grade malignant group and patients of Rappaport poorest prognosis (DU, DH). Eighty-eight per cent of the lymphomas were of B cell, 5% of T cell and 7% of non-B-non-T phenotypes. Both the Kiel and Rappaport morphologic classifications predicted survival in this selected material. Patients with B phenotypes survived longer than patients with lymphomas of non-B type. Among patients with diffuse lymphomas, those with a nodular and irregular distribution of immunoglobulin and C3d receptors tended to respond better and survived longer. No prognostic information was obtained from immunoglobulin isotypes, C3d or Fc-gamma receptors. It is concluded that the Kiel classification is equally reliable for clinical judgement as the Rappaport system and that immunological marker studies may add prognostic information.

Adult↗
PubMed1982

T cells in monoclonal gammopathies.

Subpopulations of human T lymphocytes were analysed by monoclonal antibodies (OKT3, OKT4, OKT8) in healthy controls and in patients with multiple myeloma (MM), Waldenström's macroglobulinemia (WM) and benign monoclonal gammopathy (BMG). Lymphocytes forming rosettes with SRBC correlated well with T cells staining in indirect immunofluorescence by OKT3 monoclonal antibodies. The relative and absolute numbers of OKT4+ T cells were significantly lower in patients than in controls. Though, the percentage of OKT8+ T cells was increased in patients, the total OKT8+ cell counts were normal in all patient groups. The ratio between OKT4+ and OKT8+ lymphocytes was low in the groups of treated MM and of WM patients compared to controls (P less than 0.001). Moreover, the ratio was lower than the normal range in 27% of BMG and 38% of untreated MM patients. The imbalance between OKT4+ and OKT8+ T cells in untreated MM was more pronounced in clinical stage III patients than in stage I and II patients. The most pronounced changes were noted in treated MM patients. The significance of the altered T cell subsets in monoclonal gammopathies with regard to polyclonal and tumor B cell regulation remains to be established.

Adult↗
PubMed1982

Monocyte function in Hodgkin's disease.

Monocyte functions were studied in 16 patients with Hodgkin's disease, 11 untreated and five in unmaintained complete remission. Eleven untreated patients with non-Hodgkin's lymphomas and 21 healthy persons were used as controls. Monocytes were isolated from peripheral blood and enriched to greater than 90%. Lymphoma monocytes showed normal ability to lyse human RBC coated with anti-D IgG antibodies as evaluated by a 51Cr-release assay. The ability of monocytes to augment or suppress concanavalin A stimulation of lymphocytes purified to greater than 98% was studied by incubation of a number of lymphocytes with increasing amounts of purified monocytes. The incorporation of 14C-thymidine was potentiated by a factor of 10 in the presence of equal amounts of monocytes. There was no difference between monocytes from Hodgkin, non-Hodgkin or healthy controls to augment patients' autologous or normal lymphocytes. Patient monocytes also suppressed the response at the same monocyte-lymphocyte ratio as normal monocytes. Stimulation of patient lymphocytes without the addition of monocytes was usually lower than that of normal control lymphocytes. The difference between patient and control lymphocyte stimulation was preserved in the presence of monocytes. It is concluded that monocytes from patients with active Hodgkin's disease or non-Hodgkin's lymphoma have normal helper and suppressor effects on patient or normal lymphocytes stimulated by Con A and normal antibody-dependent cytotoxicity.

Antibody-Dependent Cell Cytotoxicity↗
PubMedDate not supplied

Blood lymphocyte characteristics as predictors of prognosis in chronic lymphocytic leukemia of B-cell type.

The prognostic information of blood lymphocyte characteristics and clinical findings was assessed in 62 patients with chronic lymphocytic leukemia of B cell type. Bivariate and multivariate survival analyses were performed using age, Rai stage, surface membrane immunoglobulin (smIg) isotype pattern of the leukemic clone, total lymphocyte counts, numbers of proliferating lymphocytes and T cell subpopulations. Rai stages III and IV, high numbers of blood lymphocytes in S-phase (S+) and sm mu isotype were found to be partly independent factors predicting short therapy-free survival. Patients with a sm mu+ leukemic cell clone had a shorter therapy-free and total survival compared to those with sm mu+/delta+ and sm delta+ leukemic cells. Moreover, patients with high numbers of blood S+ lymphocytes had a shorter therapy-free and total survival compared to those with few S+ cells. These prognostic variables were valid also in patients with a low tumour burden (Rai stages 0, I and II) and may thus be of clinical importance as a guideline for therapeutic intervention.

Actuarial Analysis↗
PubMedDate not supplied

Immunodeficiency and prognosis in patients with non-Hodgkin's lymphomas.

Monocyte depleted blood lymphocyte subpopulations, their functions and relation to prognosis were studied in 68 untreated adult patients with non-Hodgkin's lymphomas classified according to the Kiel nomenclature. The median observation time was 48 months (range 41-60). The mean total blood lymphocyte and T (SRBC-rosetting) cell counts were significantly decreased as compared with age-matched controls (n = 57). Twenty-five per cent of the patients had a monoclonal blood B lymphocyte population. The spontaneous lymphocyte DNA synthesis, measured as incorporation of 14C-thymidine, was increased and the response to mitogen and antigen stimulation was decreased. Blood lymphocyte counts and functions before treatment were not related to the rates of remission or survival.

Adult↗