Yuen A R, Kamel O W, Halpern J, Horning S J
Department of Medicine, Stanford University Medical Center, CA 94304, USA.
J Clin Oncol. 1995 Jul;13(7):1726-33. doi: 10.1200/JCO.1995.13.7.1726.
To describe the course of patients following histologic transformation (HT) from low-grade follicular lymphoma to intermediate- or high-grade non-Hodgkin's lymphoma.
Patients were identified from data bases in the Division of Oncology and the Department of Surgical Pathology. HT was defined as the conversion of a follicular small cleaved-cell or follicular mixed small cleaved-cell and large-cell lymphoma to a diffuse large-cell, diffuse mixed small cleaved-cell and large-cell or any high-grade lymphoma.
We analyzed the clinical course of 74 low-grade lymphoma patients with histologically proven transformation occurring from 1965 to 1988. The median time from diagnosis to HT was 66 months, and the median age at HT was 58 years. The median duration of survival after transformation was 22 months. Anatomic extent of disease at HT (limited v extensive, P = .01), prior chemotherapy (none v any, P = .01), and response to therapy (complete v partial or none, P = .005) at time of HT were identified as significant predictors of survival after HT in backward-selection Cox regression analysis. Thirty patients attained a complete response to therapy at HT. They had a median survival duration of 81 months after HT.
A subset of patients with HT from low-grade follicular lymphoma to intermediate- or high-grade lymphoma enjoys relatively long-term survival. Patients with limited disease and no previous exposure to chemotherapy have the most favorable prognosis.
描述从低度滤泡性淋巴瘤组织学转化（HT）为中度或高度非霍奇金淋巴瘤患者的病程。
从肿瘤学部门和外科病理学部门的数据库中识别患者。HT定义为滤泡性小裂细胞淋巴瘤或滤泡性小裂细胞与大细胞混合性淋巴瘤转化为弥漫性大细胞、弥漫性小裂细胞与大细胞混合性淋巴瘤或任何高度淋巴瘤。
我们分析了1965年至1988年间74例经组织学证实发生转化的低度淋巴瘤患者的临床病程。从诊断到HT的中位时间为66个月，HT时的中位年龄为58岁。转化后的中位生存时间为22个月。在向后选择Cox回归分析中，HT时疾病的解剖范围（局限型与广泛型，P = 0.01）、既往化疗情况（未化疗与曾化疗，P = 0.01）以及HT时的治疗反应（完全缓解与部分缓解或未缓解，P = 0.005）被确定为HT后生存的显著预测因素。30例患者在HT时达到完全缓解。他们在HT后的中位生存时间为81个月。
从低度滤泡性淋巴瘤组织学转化为中度或高度淋巴瘤的一部分患者享有相对长期的生存。疾病局限且既往未接受过化疗的患者预后最佳。
