Shimoyama M
Hematology-Oncology and Clinical Cancer Chemotherapy Division, National Cancer Center Hospital.
Gan To Kagaku Ryoho. 1988 Dec;15(12):3169-88.
Great progress has been made in clinical research on non-Hodgkin's lymphoma during the last 15 years. Surface marker and DNA analyses of immunoglobulin and T-cell receptor genes are essential for new classification of the disease according to the cellular origin of tumor cells. This approach resulted in the establishment of new disease entities such as adult T-cell leukemia/lymphoma(ATL), immunoblastic lymphoadenopathy (IBL)-like T-cell lymphoma, and the pleural B-lymphoma occurring in long-standing pyothorax. New retrovirus, HTLV-I, was found during studies on ATL. Prevention of HTLV-I infection is an important project. HTLV-I negative ATL was also found and is of particular interest in understanding leukemogenesis of ATL. An oncogen such as bcl-2 is important for characterization of follicular lymphoma. Prognostic factors of patients with T-lymphoma are completely different from those of B-lymphoma. Risk grouping by combination of major prognostic factors is useful for the selection of the best treatment modality and the accurate estimation of prognosis of patients at initial presentation. The effect of combination chemotherapy should be evaluated separately between T- and B-lymphomas because of the difference in response rate and prognostic factors.
在过去15年里，非霍奇金淋巴瘤的临床研究取得了巨大进展。根据肿瘤细胞的细胞起源对该疾病进行新分类时，免疫球蛋白和T细胞受体基因的表面标志物及DNA分析至关重要。这种方法促成了新疾病实体的建立，如成人T细胞白血病/淋巴瘤（ATL）、免疫母细胞淋巴结病（IBL）样T细胞淋巴瘤以及长期脓胸患者中出现的胸膜B淋巴瘤。在对ATL的研究过程中发现了新的逆转录病毒HTLV-I。预防HTLV-I感染是一项重要课题。还发现了HTLV-I阴性的ATL，这对于理解ATL的白血病发生过程尤为重要。诸如bcl-2等癌基因对于滤泡性淋巴瘤的特征描述很重要。T细胞淋巴瘤患者的预后因素与B细胞淋巴瘤患者的完全不同。通过主要预后因素的组合进行风险分组，有助于选择最佳治疗方式并准确评估初诊患者的预后。由于缓解率和预后因素存在差异，联合化疗的效果应在T细胞淋巴瘤和B细胞淋巴瘤中分别进行评估。
