Cullen M H, Lister T A, Brearley R I, Shand W S, Stansfeld A G
Cancer. 1979 Aug;44(2):645-51. doi: 10.1002/1097-0142(197908)44:2<645::aid-cncr2820440234>3.0.co;2-y.
Forty-three lymph node biopsies were performed prior to retreatment in 30 unselected patients who had relapsed following chemotherapy for advanced non-Hodgkin's lymphoma of low grade histological type. Eight patients (27%) showed unequivocal evidence of transformation to a high grade variety of lymphoma. These included 4 out of 21 cases originally having had follicular lymphoma and 4 out of 9 cases having had diffuse lymphoma. In 2 further patients with follicular lymphoma, relapse was diagnosed following examination of the bone marrow and in one the tumor had clearly transformed. In 5 of the transformed lymphomas the cell type was predominantly centroblastic, in 2 immunoblastic and in the remaining 2 centrocytic (anaplastic). Five of the 9 cases developing high grade lymphoma have died after a median interval of 5 months from transformation, whereas only 3 of 23 cases showing no change are dead. In 4 patients low grade lymphoma persisted in the bone marrow at the time of nodal transformation. The clinical circumstances at the time of rebiopsy were unhelpful in predicting transformation.
对30例未经选择的晚期低组织学类型非霍奇金淋巴瘤化疗后复发的患者进行了再治疗前的43次淋巴结活检。8例患者（27%）有明确证据显示已转化为高级别淋巴瘤。其中包括21例最初为滤泡性淋巴瘤的患者中的4例，以及9例弥漫性淋巴瘤患者中的4例。另外2例滤泡性淋巴瘤患者，经骨髓检查后诊断为复发，其中1例肿瘤已明显转化。在5例转化的淋巴瘤中，细胞类型主要为中心母细胞性，2例为免疫母细胞性，其余2例为中心细胞性（间变性）。9例发生高级别淋巴瘤的患者中有5例在转化后的中位间隔5个月后死亡，而23例无变化的患者中只有3例死亡。4例患者在淋巴结转化时骨髓中仍存在低级别淋巴瘤。再次活检时的临床情况无助于预测转化。
