Levine A M, Goldstein M, Meyer P R, Forman S J, Parker J W, Paganini-Hill A, Lukes R J, Feinstein D I
Hematol Oncol. 1985 Apr-Jun;3(2):87-98. doi: 10.1002/hon.2900030203.
Diffuse 'histiocytic' lymphoma (DHL) is heterogeneous pathologically, consisting of four subtypes within Lukes-Collins; large-cleaved (LC), large non-cleaved (LNC), immunoblastic sarcoma of B cells (B-IBS), and immunoblastic sarcoma of T-cells (T-IBS). This heterogeneity is also recognized in the Cooperative Working Formulation on non-Hodgkin's lymphoma. Prior studies have suggested clinical heterogeneity of DHL as well, although conclusions were hampered by small numbers, and lack of therapeutic uniformity. We treated 57 patients with advanced DHL, using BACOP: 22 LNC, 16 T-IBS, 13 B-IBS, six LC. Complete remission rate for LNC was 64 per cent (14/22); B-IBS was 54 per cent (7/13); LC was 33 per cent (2/6); T-IBS was 25 per cent (4/16). (p = 0.10). Median survival for LNC was 27.8 months, B-IBS was 25.9, LC was 14, T-IBS was 12.0. The survival was significantly shorter for T-IBS patients when compared to the others (p = 0.01). By multi-variate analysis, histologic subtype (p = 0.02), age (p = 0.03), and stage (p = 0.06) were significant and independent prognostic variables in predicting survival. We conclude that LNC may respond the most favourably to BACOP, whereas alternative regimens appear necessary for patients with T-IBS.
弥漫性“组织细胞性”淋巴瘤（DHL）在病理上具有异质性，在卢克斯 - 柯林斯分类中有四种亚型：大细胞性（LC）、大无裂细胞性（LNC）、B细胞免疫母细胞肉瘤（B - IBS）和T细胞免疫母细胞肉瘤（T - IBS）。这种异质性在非霍奇金淋巴瘤协作工作分类法中也得到认可。先前的研究也提示DHL存在临床异质性，尽管由于样本量小和治疗缺乏一致性，结论受到了限制。我们使用BACOP方案治疗了57例晚期DHL患者：22例LNC、16例T - IBS、13例B - IBS、6例LC。LNC的完全缓解率为64%（14/22）；B - IBS为54%（7/13）；LC为33%（2/6）；T - IBS为25%（4/16）。（p = 0.10）。LNC的中位生存期为27.8个月，B - IBS为25.9个月，LC为14个月，T - IBS为12.0个月。与其他患者相比，T - IBS患者的生存期明显更短（p = 0.01）。通过多变量分析，组织学亚型（p = 0.02）、年龄（p = 0.03）和分期（p = 0.06）是预测生存期的重要且独立的预后变量。我们得出结论，LNC对BACOP方案反应可能最有利，而对于T - IBS患者似乎需要其他治疗方案。
