Schlegelberger B, Zwingers T, Hohenadel K, Henne-Bruns D, Schmitz N, Haferlach T, Tirier C, Bartels H, Sonnen R, Kuse R
Department of Human Genetics, University of Kiel, Germany.
J Clin Oncol. 1996 Feb;14(2):593-9. doi: 10.1200/JCO.1996.14.2.593.
The aim of this study was to evaluate the significance of cytogenetic findings for the clinical outcome of patients with Angioimmunoblastic Lymphadenopathy (AILD)-Type T-cell lymphoma.
In a retrospective analysis, the cytogenetic findings of 50 patients with AILD-type T-cell lymphoma were correlated with the frequency of spontaneous and therapy-induced remissions and with survival using the statistical methods of Kaplan and Meier and the model of Cox for multivariate analysis. Treatment was not uniform because the patients were treated in different hospitals during a period of 8 years and because a standard therapy has not yet been established.
The following cytogenetic findings were associated with a significantly lower incidence of therapy-induced remissions and a significantly shorter survival duration: presence of aberrant metaphases in unstimulated cultures (P = .04 for both parameters); clones with an additional X chromosome (P = .0001 and P = .03, respectively); structural aberrations of the short arm of chromosome 1, preferentially involving 1p31-32 (P < .001 and P = .04, respectively); and complex aberrant clones with more than four aberrations (P = .0003 and P = .005, respectively). Multivariate analysis showed that these cytogenetic findings had a significant influence on survival, but therapy modalities did not. Only the presence of complex aberrant clones was an independent prognostic factor. Trisomy 3 had no effect on survival, but patients without trisomy 5 (P = .08) tended to live longer.
This is the first study that seems to indicate that cytogenetic findings have prognostic significance in AILD-type T-cell lymphoma. These results must be proven in prospective studies of homogeneously treated patients.
本研究旨在评估细胞遗传学结果对于血管免疫母细胞性淋巴结病（AILD）型T细胞淋巴瘤患者临床结局的意义。
在一项回顾性分析中，采用Kaplan-Meier统计方法和Cox模型进行多变量分析，将50例AILD型T细胞淋巴瘤患者的细胞遗传学结果与自发缓解和治疗诱导缓解的频率以及生存率进行关联分析。由于患者在8年期间在不同医院接受治疗且尚未确立标准治疗方案，因此治疗并不统一。
以下细胞遗传学结果与治疗诱导缓解的发生率显著降低和生存持续时间显著缩短相关：未刺激培养物中出现异常中期相（两个参数的P值均为0.04）；带有额外X染色体的克隆（分别为P = 0.0001和P = 0.03）；1号染色体短臂的结构畸变，优先累及1p31 - 32（分别为P < 0.001和P = 0.04）；以及具有四个以上畸变的复杂异常克隆（分别为P = 0.0003和P = 0.005）。多变量分析显示，这些细胞遗传学结果对生存有显著影响，但治疗方式没有。只有复杂异常克隆的存在是一个独立的预后因素。三体3对生存无影响，但无5号染色体三体的患者（P = 0.08）往往生存期更长。
这是第一项似乎表明细胞遗传学结果在AILD型T细胞淋巴瘤中具有预后意义的研究。这些结果必须在对接受同质化治疗患者的前瞻性研究中得到证实。
