Newcomer L N, Nerenberg M I, Cadman E C, Waldron J A, Farber L R, Bertino J R
Cancer. 1982 Aug 1;50(3):439-43. doi: 10.1002/1097-0142(19820801)50:3<439::aid-cncr2820500310>3.0.co;2-p.
Twenty-nine patients with Stage III and IV diffuse histiocytic lymphoma (DHL) were treated prospectively with cyclophosphamide, hydroxydaunorubicin, vincristine, prednisone and bleomycin (CHOP-B) or hydroxydaunorubicin, cyclophosphamide, vincristine, methotrexate with leucovorine rescue and cytosine arabinoside (ACOMLA). Twenty-six evaluable patients were reclassified blindly by the Lukes-Collins classification with five large noncleaved follicular center cell (FCC), six large cleaved FCC, three large cell unclassified, seven B-immunoblastic sarcoma and five T-immunoblastic sarcoma patients identified. There was no significant survival advantage between the two combination chemotherapy programs. Survival of the immunoblastic sarcoma patients was inferior to that of the FCC lymphoma patients (P = 0.02). There were no significant survival differences between the large cleaved FCC and noncleaved FCC subtypes. Immunoblastic sarcomas, B- and T-cell types, appear to be more resistant to standard combination chemotherapy programs and new approaches may warrant more aggressive therapy in future protocols. The large cell FCC lymphomas have an excellent prognosis.
29例Ⅲ期和Ⅳ期弥漫性组织细胞淋巴瘤（DHL）患者接受了环磷酰胺、羟基柔红霉素、长春新碱、泼尼松和博来霉素（CHOP-B）或羟基柔红霉素、环磷酰胺、长春新碱、甲氨蝶呤加亚叶酸钙解救及阿糖胞苷（ACOMLA）的前瞻性治疗。26例可评估患者通过Lukes-Collins分类法进行盲法重新分类，确定有5例大无裂滤泡中心细胞（FCC）、6例大裂FCC、3例大细胞未分类、7例B免疫母细胞肉瘤和5例T免疫母细胞肉瘤患者。两种联合化疗方案之间无显著生存优势。免疫母细胞肉瘤患者的生存率低于FCC淋巴瘤患者（P = 0.02）。大裂FCC和无裂FCC亚型之间无显著生存差异。免疫母细胞肉瘤，B细胞型和T细胞型，似乎对标准联合化疗方案更具抗性，未来方案中可能需要新的方法进行更积极的治疗。大细胞FCC淋巴瘤预后良好。
