A CLINICAL ANALYSIS OF 2 INDOLENT LYMPHOMA ENTITIES - MANTLE CELL LYMPHOMA AND MARGINAL ZONE LYMPHOMA (INCLUDING THE MUCOSA-ASSOCIATED LYMPHOID-TISSUE AND MONOCYTOID B-CELL SUBCATEGORIES) - A SOUTHWEST-ONCOLOGY-GROUP STUDY
A CLINICAL ANALYSIS OF 2 INDOLENT LYMPHOMA ENTITIES - MANTLE CELL LYMPHOMA AND MARGINAL ZONE LYMPHOMA (INCLUDING THE MUCOSA-ASSOCIATED LYMPHOID-TISSUE AND MONOCYTOID B-CELL SUBCATEGORIES) - A SOUTHWEST-ONCOLOGY-GROUP STUDY
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DOI：
10.1182/blood.v85.4.1075.bloodjournal8541075
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发表时间：
1995-02-15
期刊：
影响因子：
20.3
通讯作者：
GROGAN, TM
中科院分区：
文献类型：
--
作者：
FISHER, RI;DAHLBERG, S;GROGAN, TM
本研究的目的是（1）确定与两种新认识的病理实体相关的临床表现和自然史，称为套细胞淋巴瘤（MCL）和边缘区淋巴瘤（MZL），包括粘膜相关淋巴组织（MALT）和单核细胞样B细胞亚类，和（2）确定这些实体是否与先前分类的其他相对惰性的非霍奇金淋巴瘤在临床上不同。我们回顾了376例患者的常规病理学和临床病程，这些患者既往未接受过治疗;患有III/IV期疾病;被分类为工作制剂类别A、B、C、D或E;在西南肿瘤组（SWOG）研究编号7204、7426或7713中接受环磷酰胺、多柔比星、长春新碱、泼尼松（CHOP）治疗。所有切片均由三位病理学家进行审查，并达成一致诊断。年龄、性别、体能状态、骨髓和/或胃肠道受累、无失败生存期和总生存期在所有类别中进行比较。我们发现（1）MCL和MZL各占SWOG临床试验中既往归类为工作制剂类别A至E并接受CHOP治疗的III期或IV期患者的约10%;（2）MZL患者的无失败生存期和总生存期与工作公式分类A至E的患者相同，但单核细胞样B细胞淋巴瘤患者的无瘤生存率和总生存率高于MALT淋巴瘤患者（P分别为0.009和0.007）;及（3）没有─ MCL患者的无瘤生存期和总生存期显著差于工作分类A至E类患者（P分别为0.0002和0.0001）。总之，晚期MALT淋巴瘤患者的病程可能比以前认识到的更具侵袭性。MCL患者没有惰性淋巴瘤，是创新治疗的候选人。(C)1995年，美国血液学会。
The objectives of this study were (1) to determine the clinical presentation and natural history associated with two newly recognized pathologic entities termed mantle cell lymphoma (MCL) and marginal zone lymphoma (MZL), including the mucosa-associated lymphoid tissue (MALT) and monocytoid B-cell subcategories, and (2) to determine whether these entities differ clinically from the other relatively indolent non-Hodgkin's lymphomas with which they have been previously classified. We reviewed the conventional pathology and clinical course of 376 patients who had no prior therapy; had stage III/IV disease; were classified as Working Formulation categories A, B, C, D, or E; and received cyclophosphamide, doxorubicin, vincristine, prednisone (CHOP) on Southwest Oncology Group (SWOG) studies no. 7204, 7426, or 7713. All slides were reviewed by the three pathologists who reached a consensus diagnosis. Age, sex, performance status, bone marrow and/or gastrointestinal involvement, failure-free survival, and overall survival were compared among all the categories. We found that (1) MCL and MZL each represent approximately 10% of stage III or IV patients previously classified as Working Formulation categories A through E and treated with CHOP on SWOG clinical trials; (2) the failure-free survival and overall survival of patients with MZL is the same as that of patients with Working Formulation categories A through E, but the failure-free survival and overall survival of the monocytoid B-cell patients were higher than that of the MALT lymphoma patients (P = .009 and .007, respectively); and (3) the failure-free survival and overall survival of patients with MCL is significantly worse than that of patients with Working Formulation categories A through E (P = .0002 and .0001, respectively). In conclusion, patients with advanced stage MALT lymphomas may have a more aggressive course than previously recognized. Patients with MCL do not have an indolent lymphoma and are candidates for innovative therapy. (C) 1995 by The American Society of Hematology.