Stein R S, Magee M J, Lenox R K, Cousar J B, Collins R D, Flexner J M, Ray W, Greer J P
Department of Medicine (Hematology), Vanderbilt University School of Medicine, Nashville, Tennessee 37232.
Cancer. 1987 Dec 1;60(11):2704-11. doi: 10.1002/1097-0142(19871201)60:11<2704::aid-cncr2820601121>3.0.co;2-#.
Between 1970 and 1986 61 patients with large cleaved cell lymphoma (LCCL) were observed and treated. Median age was 56, and there were slightly more women than men (ratio, 1.4:1). Forty-four cases (72%) had both a nodular and diffuse pattern; eight cases were nodular; nine cases were diffuse. Forty-three patients (70%) had Stage III or IV disease; four patients were Stage I (7%); 14 were Stage II (23%). Bone marrow was involved in 15 of 56 evaluable patients (27%). The median survival was 57 months. It was significantly shorter in symptomatic patients (median, 20 months) than in asymptomatic patients (median, 66 months; P = 0.002). Survival time was also shorter in Stage III and IV patients (median, 46 months) compared with Stage I and II patients (median, 100+ months; P = 0.032). Survival was independent of the disease pattern, marrow involvement, age, gender, and surface immunoglobulin heavy or light chain. Among Stage III and IV patients, survival was the same in patients who received therapy initially and in those who were treated expectantly. Among 10 advanced-stage patients who did not initially receive therapy, the median time to beginning therapy was 17 months; five patients received no therapy for 40 to 96 months. Among 14 advanced-stage patients receiving therapy regarded as curative in aggressive lymphoma, 50% experienced a complete remission (CR). However, unlike other aggressive large cell lymphomas, long-term, relapse-free survival was observed in only 9% of patients as the majority of CRs were associated with relapse rather than cure. Despite the fact that it is a large cell lymphoma, LCCL is best regarded as an indolent lymphoma.
1970年至1986年间，对61例大细胞裂细胞淋巴瘤（LCCL）患者进行了观察和治疗。中位年龄为56岁，女性略多于男性（比例为1.4:1）。44例（72%）具有结节性和弥漫性两种模式；8例为结节性；9例为弥漫性。43例（70%）患者处于Ⅲ期或Ⅳ期；4例为Ⅰ期（7%）；14例为Ⅱ期（23%）。56例可评估患者中有15例（27%）骨髓受累。中位生存期为57个月。有症状患者的中位生存期（20个月）明显短于无症状患者（中位生存期66个月；P = 0.002）。Ⅲ期和Ⅳ期患者的生存期（中位生存期46个月）也短于Ⅰ期和Ⅱ期患者（中位生存期100多个月；P = 0.032）。生存期与疾病模式、骨髓受累情况、年龄、性别以及表面免疫球蛋白重链或轻链无关。在Ⅲ期和Ⅳ期患者中，初始接受治疗的患者与预期治疗的患者生存期相同。在10例最初未接受治疗的晚期患者中，开始治疗的中位时间为17个月；5例患者40至96个月未接受治疗。在14例接受侵袭性淋巴瘤根治性治疗的晚期患者中，50%实现了完全缓解（CR）。然而，与其他侵袭性大细胞淋巴瘤不同，只有9%的患者观察到长期无复发生存，因为大多数CR与复发而非治愈相关。尽管LCCL是一种大细胞淋巴瘤，但最好将其视为惰性淋巴瘤。
