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Diffuse small cleaved-cell lymphoma: a heterogeneous disease with distinct immunobiologic subsets.

C P Leith·C M Spier·T M Grogan·G Gonzales·C S Rangel·J A Rybski·M Matzner·T P Miller
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Abstract

PURPOSE AND METHODS: Diffuse small cleaved-cell lymphoma (DSCL) is a relatively uncommon non-hodgkin's lymphoma (NHL) in the United States and has not been the subject of recent in-depth study of factors predictive of outcome. It is unique among the NHL of intermediate grade because there is no evidence of a curable subset of patients. To investigate whether any laboratory data might predict outcome, we studied 33 cases collected during a 12-year period and correlated morphology, immunohistochemistry, and serum lactate dehydrogenase (LDH) with clinical data and outcome. RESULTS: We found that proliferative rate (Ki-67), cell lineage (T v B cell), and serum LDH were associated with significant differences in survival. A Ki-67 value greater than or equal to 20% was associated with a median survival of 20 months compared with 80 months for lower values (P = .0002); patients with tumors of T-cell lineage had a median survival of 20 months compared with 40 months for those with B-cell neoplasms (P = .0143); and a serum LDH greater than 225 IU/L was associated with a median survival of 8 months compared with 40 months for lower LDH levels (P = .0004). Blastoid morphology was also linked to a trend toward poor outcome (P = .08). Neither a history of low-grade lymphoma nor the presence of residual immunologically detectable follicles influenced outcome (P = .93 and .97, respectively). CONCLUSION: We conclude that high Ki-67, high LDH, and T-cell lineage each identify DSCL patients with poor outcome.

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AdultAgedB-LymphocytesCell DivisionFemaleHumansImmunophenotypingKi-67 AntigenL-Lactate DehydrogenaseLymphocyte SubsetsLymphoma, Non-HodgkinMaleMiddle AgedNuclear ProteinsPredictive Value of TestsPrognosisSurvival AnalysisT-LymphocytesComparative StudyJournal ArticleResearch Support, Non-U.S. Gov'tResearch Support, U.S. Gov't, P.H.S.

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C P Leith, C M Spier, T M Grogan, G Gonzales, C S Rangel, J A Rybski, M Matzner, T P Miller. 1992. Diffuse small cleaved-cell lymphoma: a heterogeneous disease with distinct immunobiologic subsets.. https://doi.org/10.1200/jco.1992.10.8.1259

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