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Annals of Oncology pp 123–129Cite as

Follicular lymphomas: Assessment of prognostic factors in 127 patients followed for 10 years

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Summary

Response to treatment, histologic progression, and survival of 127 patients with follicular lymphoma were analyzed according to histologic, clinical, and biological parameters. Histologic parameters were percentage of large cells (<10%, 41 patients; 10–25%, 38 patients; 25–50%, 11 patients; ≥50%, 30 patients), percentage of diffuse areas, presence of intrafollicular proliferation or fibrosis, and mitotic scale. Eighty percent of the patients achieved complete remission (CR) with radiotherapy for localized stages and various chemotherapy regimens for disseminted stages. Three patients did not respond to treatment, and 23 were in partial remission (PR) at the end of treatment. Median survival time was 9.25 years. A constant death rate of 8% per year was observed without plateau. Histologic progression was observed in 32 patients; it occurred at a constant rate during the first six years and plateaued thereafter. Factors associated with low response rate were stage IV, B symptoms, high tumor mass, and two or more extranodal sites. Factors associated with histologic progression were bone marrow involvement and two or more extranodal sites. Factors associated with poor survival were advanced stage, two or more extra-nodal sites, bone marrow involvement, high lactate dehydrogenase level, and absence of interfollicular fibrosis. The percentages of large cells and diffuse areas had no influence on prognosis, nor had the type of treatment. Median survival has not been reached for CR patients and was four years for PR patients (P <0.0001). The LNH-84 prognostic index for aggressive lymphomas, based on tumor mass, number of extranodal sites, stage, and LDH level, is a clear-cut indicator of prognosis in follicular lymphomas too. This study shows that the prognosis of follicular lymphoma patients is related to clinical and biological parameters of a high tumor mass and to response to treatment, but not to classical histologic parameters.

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References

  1. Lukes RJ, Collins RD. Immunologic characterization of human malignant lymphomas. Cancer 1974; 34: 1488–1503.

    Article  PubMed  Google Scholar 

  2. The non-Hodgkin’s lymphoma pathologic classification project. National Cancer Institute sponsored study of classifications of non-Hodgkin’s lymphomas. Summary and description of a Working Formulation for clinical usage. Cancer 1982; 49: 2112–2135.

    Article  Google Scholar 

  3. Jones SE. Follicular lymphoma. Do no harm. Cancer Treat Rep 1986; 70: 1055–1058.

    PubMed  CAS  Google Scholar 

  4. Acker B, Hoppe RT, Colby TV et al. Histologic conversion in the non-Hodgkin’s lymphomas. J Clin Oncol 1983; 1: 11–16.

    PubMed  CAS  Google Scholar 

  5. Garvin AJ, Simon RM, Osborne CK et al. An autopsy study of histologic progression in non-Hodgkin’s lymphomas. 192 cases from the National Cancer Institute. Cancer 1983; 52: 393398.

    Google Scholar 

  6. Coiffier B, Sebban C, Berger F et al. Transformation histologique des syndromes lymphoprolifératifs de faible malignité. Etude clinique et évolutive de 32 cas. Presse Med 1985; 14: 1229–1236.

    PubMed  CAS  Google Scholar 

  7. Gospodarowicz MK, Bush Rs, Brown TC et al. Prognostic factors in nodular lymphomas: a multivariate analysis based on the Pricess Margaret Hospital experience. Int J Radiat Oncol Biol Phys 1984; 10: 489–497.

    Article  PubMed  CAS  Google Scholar 

  8. Hoppe RT, Kushlan P, Kaplan HS et al. The treatment of advanced stage favorable histology non-Hodgkin’s lymphoma: A preliminary report of a randomized trial comparing single agent chemotherapy, combination chemotherapy and whole body irradiation. Blood 1981; 58: 592–598.

    PubMed  CAS  Google Scholar 

  9. Anderson T, Bender RA, Fisher RI et al. Combination chemotherapy in non-Hodgkin’s lymphoma: results of long-term follow-up. Cancer Treat Rep 1977; 61: 1057–1066.

    PubMed  CAS  Google Scholar 

  10. Ezdinli EZ, Costello WFG, Icli F et al. Nodular mixed lymphocytic histiocytic lymphoma. Response and survival. Cancer 1980; 45: 261–267.

    Article  PubMed  CAS  Google Scholar 

  11. Longo DL, Young RC, Hubbard SM et al. Prolonged initial remission in patients with nodular mixed lymphoma. Ann Intern Med 1984; 100: 651–656.

    Article  PubMed  CAS  Google Scholar 

  12. Glick JH, Barnes JM, Ezdinli EZ et al. Nodular mixed lymphoma: results of a randomized trial failing to confirm prolonged disease-free survival with COPP chemotherapy. Blood 1981; 58: 920–925.

    PubMed  CAS  Google Scholar 

  13. Osborne CK, Norton L, Young RC et al. Nodular histiocytic lymphoma: An aggressive nodular lymphoma with potential for prolonged disease-free survival. Blood 1980; 56: 98–103.

    PubMed  CAS  Google Scholar 

  14. Horning SJ, Weiss LM, Nevitt JB et al. Clinical and pathologic features of follicular large cell (nodular histiocytic) lymphoma. Cancer 1987; 59: 1470–1474.

    Article  PubMed  CAS  Google Scholar 

  15. Kantarjian HM, McLaughlin P, Fuller LM et al. Follicular large cell lymphoma: analysis and prognostic factors in 62 patients. J Clin Oncol 1984; 2: 811–819.

    PubMed  CAS  Google Scholar 

  16. Metter GE, Nathwani BN, Burke JS et al. Morphological subclassification of follicular lymphoma: variability of diagnoses among hematopathologists. A collaborative study between the Repository Center and Pathology Panel for Lymphoma Clinical Studies. J Clin Oncol 1985; 1: 25–38.

    Google Scholar 

  17. Nathwani BN, Metter GE, Miller TP et al. What should be the morphologic criteria for the subdivision of follicular lymphomas? Blood 1986; 68: 837–845.

    PubMed  CAS  Google Scholar 

  18. Takvorian T, Canellos GP, Ritz J et al. Prolonged disease-free survival after autologous bone marrow transplantation in patients with non-Hodgkin’s lymphoma with a poor prognosis. N Engl J Med 1987; 316: 1499–1505.

    Article  PubMed  CAS  Google Scholar 

  19. Schouten HC, Bierman PJ, Vaughan WP et al. Autologous bone marrow transplantation in follicular non-Hodgkin’s lymphoma before and after histologic transformation. Blood 1989; 74: 2579–2584.

    PubMed  CAS  Google Scholar 

  20. Glick JH, McFadden E, Costello W et al. Nodular histiocytic lymphoma: factors influencing prognosis and implications for aggressive chemotherapy. Cancer 1982; 49: 840–845.

    Article  PubMed  CAS  Google Scholar 

  21. Anderson T, DeVita VT, Simon RM et al. Malignant lymphoma. II. Prognostic factors and response to treatment of 473 patients at the National Cancer Institute. Cancer 1982; 50: 2708–2721.

    Article  PubMed  CAS  Google Scholar 

  22. Ezdinli EZ, Costello WG, Kucuk O et al. Effect of the degree of nodularity on the survival of patients with nodular lymphomas. J Clin Oncol 1987; 5: 413–418.

    PubMed  CAS  Google Scholar 

  23. Warnke RA, Kim H, Fuks Z et al. The coexistence of nodular and diffuse patterns in nodular non-Hodgkin’s lymphomas. Significance and clinicopathologic correlation. Cancer 1977; 40: 1229–1233.

    Article  PubMed  CAS  Google Scholar 

  24. Schultz HB, Ersboll J, Hougaard P. Prognostic significance of architectural patters in non-Hodgkin’s lymphomas. Scand J Haematol 1985; 35: 270–283.

    Article  PubMed  CAS  Google Scholar 

  25. Lepage E, Sebban C, Gisselbrecht C et al. Treatment of low-grade non-Hodgkin’s lymphomas: assessment of doxorubicin in a controlled trial. Hematol Oncol 1990; 8: 31–39.

    Article  PubMed  CAS  Google Scholar 

  26. Kaplan EL, Meier P. Nonparametric estimation for incomplete observations. J Amer Stat Assoc 1958; 53: 157–181.

    Google Scholar 

  27. Cox DR. The analysis of binary data. New York, Chapman and Hall, 1970.

    Google Scholar 

  28. Cox DR. Regression models and life tables. J Roy Stat Soc [B] 1972; 34: 187–202.

    Google Scholar 

  29. Weisenburger DD, Kim H, Rappaport H. Mantle-zone lymphoma: A follicular variant of intermediate lymphocytic lymphoma. Cancer 1982; 49: 1429–1438.

    Article  PubMed  CAS  Google Scholar 

  30. Coiffier B, Gisselbrecht C, Vose JM et al. Prognostic factors in aggressive malignant lymphomas: description and validation of a prognostic index that could identify patients requiring a more intensive therapy. J Clin Oncol 1990: to be published.

    Google Scholar 

  31. Jacobs P, King HS. A randomized prospective comparison of chemotherapy to total body irradiation as initial treatment for the indolent lymphoproliferative diseases. Blood 1987; 69: 1642–1646.

    PubMed  CAS  Google Scholar 

  32. Mann RB, Berard CW. Criteria for the cytologic subclassification of follicular lymphomas: a proposed alternative method. Hematol Oncol 1983; 1: 187–192.

    Article  PubMed  CAS  Google Scholar 

  33. Hu E, Weiss LM, Hoppe RT et al. Follicular and diffuse mixed small-cleaved and large-cell lymphoma. A clinicopathologic study. J Clin Oncol 1985; 3: 1183–1187.

    PubMed  CAS  Google Scholar 

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Author information

Authors and Affiliations

  1. Service d’Hématologie, Centre Hospitalier Lyon-Sud, Pierre-Bénite, France

    Yves Bastion & Professeur Bertrand Coiffier

  2. Service d’Anatomie Pathologique, Hôpital Edouard-Herriot, Lyon, France

    Françoise Berger

  3. Laboratoire de Cytologie Analytique, Université Claude-Bernard, Lyon, France

    Paul-André Bryon

  4. Laboratoire d’Hématologie, Centre Hospitalier Lyon-Sud, Pierre-Bénite, France

    Pascale Felman

  5. Service d’Hématologie, Hôpital Edouard-Herriot, Lyon, France

    Martine Ffrench

Authors
  1. Yves Bastion
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  2. Françoise Berger
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  3. Paul-André Bryon
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  4. Pascale Felman
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  5. Martine Ffrench
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  6. Professeur Bertrand Coiffier
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Editor information

Editors and Affiliations

  1. Section of Hematology/Oncology, Department of Medicine, The University of Chicago Cancer Research Center, Chicago, Illinois, USA

    John E. Ultmann  & Brian L. Samuels  & 

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© 1991 Springer Science+Business Media Dordrecht

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Bastion, Y., Berger, F., Bryon, PA., Felman, P., Ffrench, M., Coiffier, B. (1991). Follicular lymphomas: Assessment of prognostic factors in 127 patients followed for 10 years. In: Ultmann, J.E., Samuels, B.L. (eds) Annals of Oncology. Springer, Boston, MA. https://doi.org/10.1007/978-1-4899-7305-4_19

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  • DOI: https://doi.org/10.1007/978-1-4899-7305-4_19

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4899-7294-1

  • Online ISBN: 978-1-4899-7305-4

  • eBook Packages: Springer Book Archive

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