A significant diffuse component predicts for inferior survival in grade 3 follicular lymphoma, but cytologic subtypes do not predict survival
A significant diffuse component predicts for inferior survival in grade 3 follicular lymphoma, but cytologic subtypes do not predict survival
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DOI：
10.1182/blood-2002-07-2298
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发表时间：
2003-03-15
期刊：
影响因子：
20.3
通讯作者：
Armitage, JO
中科院分区：
文献类型：
--
作者：
Hans, CP;Weisenburger, DD;Armitage, JO
3级滤泡性淋巴瘤（FL3）被认为具有侵袭性临床过程。基于可能的生物学差异，新的世界卫生组织（WHO）淋巴瘤分类建议将FL3进一步细分为3a级和3b级，并指出也应报告弥漫性大B细胞淋巴瘤（DLBCL）累及的百分比。然而，这些特征的临床意义尚不清楚。因此，我们研究了190例接受含蒽环类药物联合化疗的新诊断的淋巴结为基础的FL3患者。根据WHO标准，滤泡成分被细分为3a级（FL3a）或3b级（FL3b），或滤泡大裂细胞型（FLC）。还记录了扩散组分（如果存在）的百分比。在196例病例中，有107例FL3a（56%），53例FL3b（28%）和30例FLC（16%）病例。在72例病例中观察到弥漫性区域（31例FL3a，28例FL3b和13例FLC）。FL3a、FL3b或FLC级患者的临床特征、总生存期或无事件生存期无显著差异。然而，那些弥漫性成分占主导地位的病例（>50%弥漫性）的总生存率（P= 0.0037）和无事件生存率（P= 0.012）明显较差。因此，我们得出结论，FL3的细胞学亚型的细分似乎并不重要的临床。然而，弥漫性成分超过50%的FL3患者的生存率较低，与DLBCL患者的生存率相似。
Grade 3 follicular lymphoma,(FL3) is thought to have an aggressive clinical course. On the basis of possible biologic differences, the new World Health Organization (WHO) classification of lymphoma suggests further subdivision of FL3 into grades 3a and 3b and states that the percentage of involvement by diffuse large B-cell lymphoma (DLBCL) should also be reported. However, the clinical implications of these features are unclear. Therefore, we studied 190 newly diagnosed patients with lymph node-based FL3 who received anthracycline-containing combination chemotherapy. The follicular component was subclassified as grade 3a (FL3a) or grade 3b (FL3b) according to the WHO criteria, or as follicular large cleaved cell type (FLC). The percentage of a diffuse component, if present, was also recorded. Of the 196 cases, there were 107 FL3a (56%), 53 FL3b (28%), and 30 FLC (16%) cases. Diffuse areas were seen in 72 cases (31 FL3a, 28 FL3b, and 13 FLC). There were no significant differences in the clinical characteristics, overall survival, or event-free survival between patients with grades FL3a, FL3b, or FLC. However, those cases with a predominant diffuse component (>50% diffuse) had a significantly worse overall survival (P=.0037) and event-free survival (P=.012). Therefore, we conclude that the subdivision of FL3 into cytologic subtypes does not appear to be important clinically. However, patients with FL3 having a diffuse component of more than 50% have an inferior survival that is similar to the survival of those with DLBCL.