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| Subclassification of diffuse large B-cell lymphomas according to the Kiel classification: Distinction of centroblastic and immunoblastic lymphomas is a significant prognostic risk factor |
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| Author(s): Engelhard M, Brittinger G, Huhn D, Gerhartz HH, Meusers P, Siegert W, Thiel E, Wilmanns W, Aydemir U, Bierwolf S, Griesser H, Tiemann M, Lennert K |
| Source: BLOOD Volume: 89 Issue: 7 Pages: 2291-2297 Published: APR 1 1997 |
| Times Cited: 64 References: 36 |
| Abstract: Among high-grade malignant non-Hodgkin's lymphomas the updated Kiel classification identifies three major B-cell entities: centroblastic (CB), B-immunoblastic (B-IB), and B-large cell anaplastic (Ki-1(+)) (now termed anaplastic large cell [CD30(+)], [B-ALC]). The clinical prognostic relevance of this distinction was evaluated in a randomized prospective treatment trial (COP-BLAM/IMVP-16 regimen randomly combined +/- radiotherapy in complete responders) conducted in adult (age 15 to 75) patients with Ann Arbor stage II-IV disease (n = 219) diagnosed by optimal histomorphology (Giemsa staining) and by immunohistochemistry. Overall survival was significantly better in CB lymphoma as compared to B-IB (P =.0002) or B-ALC (P =.046). Relapse-free survival was worse for B-IB (P =.0003) as compared to CB lymphomas. The prognostic differences between CB and BIB were confirmed by multivariate analyses including the risk factors of the International Index. Overall survival was significantly determined by performance status (P =.0003), serum-LDH (P =.036), and B-IB histology subtype (P =.036). Relapse-free survival was influenced by age (P =.007) and histological subtype (P =.007). Thus, the diagnosis of the CB and B-IB lymphomas by the histological criteria of the Kiel classification was identified as an independent prognostic factor in diffuse large B-cell lymphomas. (C) 1997 by The American Society of Hematology. |
| Document Type: Article |
| Language: English |
| Reprint Address: Engelhard, M (reprint author), UNIV ESSEN GESAMTHSCH KLINIKUM, DIV HEMATOL, DEPT MED, HUFELANDSTR 55, D-45147 ESSEN, GERMANY |
Addresses:
1. HUMBOLDT UNIV BERLIN, VIRCHOW KLINIKUM, DEPT MED HEMATOL ONCOL, BERLIN, GERMANY
2. FREE UNIV BERLIN, KLINIKUM BENJAMIN FRANKLIN, DEPT MED HEMATOL ONCOL, D-12200 BERLIN, GERMANY
3. UNIV MUNICH, KLINIKUM GROSSHADERN, DEPT MED 3, D-8000 MUNICH, GERMANY
4. BIOMETR CTR THERAPEUT STUDIES, D-8000 MUNICH, GERMANY
5. CTR PATHOL & APPL CANC RES, KIEL, GERMANY
6. UNIV WURZBURG, INST PATHOL APPL CYTOL, WURZBURG, GERMANY |
| Publisher: W B SAUNDERS CO, INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 |
| Subject Category: Hematology |
| IDS Number: WQ359 |
| ISSN: 0006-4971 |
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