Histologic progression in non-Hodgkin's lymphoma.
Histologic progression in non-Hodgkin's lymphoma.
复制标题
非霍奇金淋巴瘤的组织学进展。
DOI：
10.1182/blood.v59.2.258.258
复制
发表时间：
1982
期刊：
影响因子：
20.3
通讯作者：
R. Young
中科院分区：
文献类型：
--
作者：
S. Hubbard;B. Chabner;V. Devita;R. Simon;C. Berard;R. Jones;A. Garvin;G. Canellos;C. Osborne;R. Young
对连续515例非霍奇金淋巴瘤患者的临床病程和活检标本进行了回顾性评估，试图确定组织学随时间推移而记录的变化的临床重要性。这些患者中有205人被初步诊断为结节性淋巴瘤，并进行了回顾分析。63例患者在首次诊断后6个月内进行了重复活检。在23例患者中，这些重复活检显示组织学改变为弥漫性模式和/或较大的组织细胞类型，而另40例(63%)重复活检显示盘状持续结节模式，基本细胞类型没有明显变化。从19名患者(30%)的重复活检中发现，从结节状淋巴瘤进展为弥漫性组织细胞型、混合型或未分化的拉帕波特淋巴瘤。活检显示组织学改变后的生存预后与最近一次活检所显示的组织学以及对后续药物治疗的反应有关。这19名患者重复活检后的存活时间明显短于组织学仍为结节的40名患者(p<；0.001)。然而，强化联合化疗获得完全缓解与8名以上患者的生存时间延长和1名患者的无瘤生存时间延长有关。由于之前的治疗可能会损害结节淋巴瘤患者发生侵袭性弥漫组织学的患者对化疗完全有效的能力，因此在设计未来的结节淋巴瘤临床试验时必须考虑组织学进展的可能性。组织学进展并不排除对强化化疗的完全反应。
The clinical course and biopsy specimens from 515 consecutive non-Hodgkin's lymphoma patients was evaluated retrospectively in an attempt to determine the clinical importance of documented changes in histology over time. Two-hundred and five of these patients has an initial diagnosis of nodular lymphoma and were reviewed for this anaysis. Sixty-three underwent a repeat biopsy greater than 6 mo after initial diagnosis. In 23 patients, these repeat biopsies revealed a change in histology to a diffuse pattern and/or a change to a larger ''histiocytic'' cell type, while repeat biopsies for the other 40 (63%) disclosd persistence of a nodular pattern and no clear change in basic cell type. Progression from nodular lymphoma to diffuse histiocytic, mixed, or undifferentiated types of lymphomas of Rappaport was found in repeate biopsies obtained from 19 patients (30%). Prognosis for survival following a biopsy that demonstrated histologic change was related to the histology demonstrated at the most recent biopsy and to the response to subsequent drug treatment. Survival following repeat biopsy for these 19 patients was significantly shorter than for the 40 patients whose histology remained nodular (p < 0.001). However, attainment of a complete remission with intensive combination chemotherapy was associated with prolonged survival inmore » eight patients and prolonged disease-free survival in one patient. Since prior treatment may compromise the ability to achieve a complete response to chemotherapy in patients with nodular lymphoma who develop an aggressive diffuse histology, the likelihood of histologic progression must be considered in the design of future clinical trials in nodular lymphoma. Histologic progression does not preclude attainment of a complete response to intensive chemotherapy.« less
惰性非霍奇金淋巴瘤的治疗。
影响因子：
4
作者：
Portlock,CS
通讯作者：
Portlock,CS