Abstract
The classification of lymphomas proposed by Rappaport et al. [1] in 1966 brought order to the chaos surrounding the non-Hodgkin’s lymphomas. This classification, based on the presence or absence of a nodular pattern of nodal involvement and on the degree of differentiation of the malignant cells, stimulated much of the work presented at this symposium. It served a useful purpose in identifying the nodular pattern as carrying a favorable prognostic import when compared to the diffuse pattern. In addition, it called attention to the differing natural histories and patterns of disease progression associated with the major Rappaport classifications. It was in this context that, in 1971, the National Cancer Insititute (NCI) initiated a study of the patterns of organ involvement and response to therapy of each of the lymphoma subclasses (2). An important aspect of this study was the ordered, sequential nature of the staging procedures used (Table 1). The staging approach used involved an initial battery of procedures including lymphangiogram, bone marrow, and percutaneous liver biopsy which served to identify a significant proportion of those with stage IV disease. Those patients with negative percutaneous liver biopsies were subject to peritoneoscopy with multiple liver biopsies and if still negative with respect to liver disease, then laparotomy. Table 2 illustrates the upstaging which resulted from the procedures used. It also emphasizes that a majority of the patients were staged adequately without laparotomy. Thus, this staging approach gave all of the advantages of aggressive clinical staging while limiting laparotomy to the minority of patients where it is of value. This NCI study and the work of others have served to clarify the natural history of the non-Hodgkin’s lymphomas (Table 3).
Keywords
- Acute Lymphocytic Leukemia
- Chronic Lymphocytic Leukemia
- Adenosine Deaminase
- Staging Approach
- Percutaneous Liver Biopsy
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsPreview
Unable to display preview. Download preview PDF.
References
Broder, S., Humphrey, R., Durm, M., Blackman, M., Meade, B., Goldman, C., Strober, W., Waldmann, T.: Impaired Synthesis of Polyclonal Immunoglobulins by circulating lymphocytes from Patients with Multiple Myeloma. N. Engl. J. Med. 293, 887 (1975)
Chabner, B. A., Johnson, R. E., Young, R. C., Canellos, G. P., Hubbard, S. P., Johnson, S. K., De Vita, V. T.: Sequential Non-Surgical and Surgical Staging of non-Hodgkin’s Lymphoma. Ann. Inter. Med.85, 149 (1976)
Dow, L. W., George, S. L., Mauer, A. M.: Predictive Models for Lymphoblastic leukemia. Proc. Am. Assoc. Cancer Res. 18, 63 (1977)
Jaffe, E. S., Shevach, E. M., Frank, M. M., Bernard, C. W., Green, I.: Nodular lymphoma- Evidence for Origin from Follicular B Lymphocytes. N. Engl. J. Med.290, 813 (1974)
Konior, G. S., Lippman, M. E., Johnson, G. E., Leventhal, B. G.: Correlation of Glucocorticoid Receptor Levels and Complete Remission Duration in Poor Prognosis Acute lymphocytic leukemia. Proc. Am. Soc. Clin. Oncology 18, C346 (1977)
McCaffrey, R., Harrison, T. A., Parkman, R., Baltimore, D.: Terminal Deoxynucleotidyl Transferase Activity in Human Leukemic Cells and in Normal Human Thymocytes. N. Engl. J. Med. 292: 775 (1975)
Rappaport, H., Winter, W. J., Hicks, E. B.: A Re-evaluation of its Position in the Scheme of malignant lymphoma, Based on Survey of 253 cases. Cancer 9, 792 (1956)
Smythe, J., Poplack, D. G., Holiman, B. J., Leventhal, B. J., Magrath, I. T.: Correlation of Adenosine Deaminase Activity and Cell Surface Markers in Leukemic Lymphoblasts. Proc. Am. Assoc. Cancer Res. 18, 856 (1977)
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1978 Springer-Verlag Berlin · Heidelberg
About this chapter
Cite this chapter
Myers, C.E., Chabnev, B.A. (1978). General Strategy of Staging and Therapy of Non-Hodgkin’s Lymphomas. In: Mathé, G., Seligmann, M., Tubiana, M. (eds) Lymphoid Neoplasias II. Recent Results in Cancer Research, vol 65. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-81249-1_17
Download citation
DOI: https://doi.org/10.1007/978-3-642-81249-1_17
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-642-81251-4
Online ISBN: 978-3-642-81249-1
eBook Packages: Springer Book Archive