Cheng A L, Chen Y C, Wang C H, Su I J, Hsieh H C, Chang J Y, Hwang W S, Su W C, Liu T W, Tien H F
Department of Internal Medicine, National Taiwan University Hospital, Taipei, ROC.
J Clin Oncol. 1989 Jun;7(6):725-31. doi: 10.1200/JCO.1989.7.6.725.
Peripheral T-cell lymphoma (PTCL) forms a morphologically heterogeneous group of non-Hodgkin's lymphomas (NHL) with distinct immunophenotypes of mature T cells. Progress has been slow in defining specific clinicopathological entities to this particular group of NHL. In order to elucidate the specific characteristics of PTCL, a direct comparison of PTCL with a group of diffuse B-cell lymphomas (DBCL) was performed. Between June 1983 and December 1987, we studied 114 adults with NHL, using a battery of immunophenotyping markers. Adult T-cell leukemia/lymphoma, lymphoblastic lymphoma, mycosis fungoides/Sézary syndrome, follicular lymphoma, well-differentiated lymphocytic lymphoma, and true histiocytic lymphoma were excluded from this study since these are distinct clinicopathologic entities with well-recognized immunophenotypes. Of the remaining 75 patients, 70 who had adequate clinical information were analyzed, and of these, 34 were PTCL and 36 were DBCL. Classified according to the National Cancer Institute (NCI) Working Formulation (WF), 68% of PTCL and 31% of DBCL were high-grade lymphomas. Clinical and laboratory features were similar, except PTCL had a characteristic skin involvement and tended to present in more advanced stages with more constitutional symptoms. Induction chemotherapy was homogeneous in both groups, and complete remission rates were 62% for PTCL and 67% for DBCL. Patients with DBCL had a better overall survival than patients with PTCL, but the survival benefit disappeared after patients were stratified according to intermediate- or high-grade lymphoma. A subgroup of PTCL patients who had received less intensive induction chemotherapy was found to have a very unfavorable outcome. We conclude that (1) PTCL follows the general grading concept proposed in WF classification; (2) within a given intermediate or high grade, PTCL and DBCL respond comparably to treatment; (3) the intensity of induction chemotherapy has a crucial impact on the outcome of PTCL patients; and (4) with a few exceptions, the clinical and laboratory features of PTCL and DBCL are comparable.
外周T细胞淋巴瘤（PTCL）是一组形态学上异质性的非霍奇金淋巴瘤（NHL），具有成熟T细胞独特的免疫表型。在确定这一特定类型的NHL的具体临床病理实体方面进展缓慢。为了阐明PTCL的具体特征，我们对PTCL与一组弥漫性B细胞淋巴瘤（DBCL）进行了直接比较。1983年6月至1987年12月期间，我们使用一系列免疫表型标记物对114例成人NHL患者进行了研究。本研究排除了成人T细胞白血病/淋巴瘤、淋巴母细胞淋巴瘤、蕈样霉菌病/赛塞里综合征、滤泡性淋巴瘤、高分化淋巴细胞淋巴瘤和真性组织细胞淋巴瘤，因为这些是具有公认免疫表型的不同临床病理实体。在其余75例患者中，对70例有充分临床资料的患者进行了分析，其中34例为PTCL，36例为DBCL。根据美国国立癌症研究所（NCI）工作分类法（WF）分类，68%的PTCL和31%的DBCL为高级别淋巴瘤。临床和实验室特征相似，但PTCL有特征性的皮肤受累，且倾向于在更晚期出现，伴有更多的全身症状。两组的诱导化疗方案相同，PTCL的完全缓解率为62%，DBCL为67%。DBCL患者的总生存率优于PTCL患者，但在根据中级或高级别淋巴瘤进行分层后，生存获益消失。发现一组接受强度较低诱导化疗的PTCL患者预后非常差。我们得出结论：（1）PTCL遵循WF分类法中提出的一般分级概念；（2）在给定的中级或高级别内，PTCL和DBCL对治疗的反应相当；（3）诱导化疗的强度对PTCL患者的预后有至关重要的影响；（4）除少数例外，PTCL和DBCL的临床和实验室特征具有可比性。
