Clinical significance of immunophenotype in diffuse aggressive non-Hodgkin's lymphoma

James Olen Armitage, Julie Marie Vose, James Linder, D. Weisenburger, D. Harrington, J. Casey, Philip Jay Bierman, S. Sorensen, M. Hutchins, D. F. Moravec, D. Howe, M. D. Dowling, J. Mailliard, P. S. Johnson, W. Pevnick, W. M. Packard, J. Okerbloom, R. F. Thompson, R. M. Langdon

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Abstract

We performed a prospective study of the clinical significance of immunophenotype in 110 patients with aggressive non-Hodgkin's lymphoma (NHL) treated by oncologists in the Nebraska Lymphoma Study Group between October 1982 and May 1986. All patients were immunophenotyped from biopsies performed before therapy was administered. The patients were treated with a uniform protocol of radiotherapy for minimal nonbulky, stage I or II disease (seven patients) or a single, six-drug chemotherapy regimen cyclophosphamide, doxorubicin, procarbazine, bleomycin, vincristine, and prednisone (CAP-BOP) in patients with more extensive disease (103 patients). Ninety-one patients (83%) had B-cell lymphoma and 19 patients (17%) had T-cell lymphoma. The histologic diagnosis of diffuse mixed-cell lymphoma was significantly associated with T-cell immunophenotype (45% v 5%; P < .001), and the diagnosis of diffuse large-cell lymphoma was significantly associated with B-cell immunophenotype (40% v 5%; P = .006). However, no significant difference in frequency of prognostic variables such as age, stage, systemic symptoms, tumor bulk, serum lactic dehydrogenase, or performance status was found between the B-cell and T-cell groups. Patients with B-cell NHL had a slightly higher complete remission rate (74% v 53%; P = NS), similar durability of complete remission (75% v 70% at 3 years; P = NS), and a slightly but not significantly better overall survival (50% v 41% at 3 years, P = NS). The slight advantage in response rate and survival for B-cell patients was related to a very poor outcome for patients with stage IV T-cell NHL. For patients with stage I to III disease, neither the complete remission rate (B-cell, 82% v T cell, 91%; P = NS) nor overall survival (3-year survival for B cell, 58% v T cell, 73%; P = NS) were significantly different. However, with stage IV disease B-cell patients fared far better than those with T-cell NHL for both complete remission rate (67% v 0%; P = .002) and overall survival (3-year survival, 44% v 0%; P = .002). Immunophenotyping intermediate- and high-grade NHL allowed identification of a subgroup of patients who had a very poor prognosis with this treatment approach and for whom alternate therapy might be considered.

Original languageEnglish (US)
Pages (from-to)1783-1790
Number of pages8
JournalJournal of Clinical Oncology
Volume7
Issue number12
DOIs
StatePublished - Jan 1 1989

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Non-Hodgkin's Lymphoma
B-Lymphocytes
T-Cell Lymphoma
Survival
T-Lymphocytes
B-Cell Lymphoma
Procarbazine
Immunophenotyping
Lymphoma, Large B-Cell, Diffuse
Bleomycin
Vincristine
Prednisone
Doxorubicin
Cyclophosphamide
Lymphoma
Oxidoreductases
Milk
Radiotherapy
Therapeutics
Survival Rate

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Clinical significance of immunophenotype in diffuse aggressive non-Hodgkin's lymphoma. / Armitage, James Olen; Vose, Julie Marie; Linder, James; Weisenburger, D.; Harrington, D.; Casey, J.; Bierman, Philip Jay; Sorensen, S.; Hutchins, M.; Moravec, D. F.; Howe, D.; Dowling, M. D.; Mailliard, J.; Johnson, P. S.; Pevnick, W.; Packard, W. M.; Okerbloom, J.; Thompson, R. F.; Langdon, R. M.

In: Journal of Clinical Oncology, Vol. 7, No. 12, 01.01.1989, p. 1783-1790.

Research output: Contribution to journalArticle

Armitage, JO, Vose, JM, Linder, J, Weisenburger, D, Harrington, D, Casey, J, Bierman, PJ, Sorensen, S, Hutchins, M, Moravec, DF, Howe, D, Dowling, MD, Mailliard, J, Johnson, PS, Pevnick, W, Packard, WM, Okerbloom, J, Thompson, RF & Langdon, RM 1989, 'Clinical significance of immunophenotype in diffuse aggressive non-Hodgkin's lymphoma', Journal of Clinical Oncology, vol. 7, no. 12, pp. 1783-1790. https://doi.org/10.1200/JCO.1989.7.12.1783
Armitage, James Olen ; Vose, Julie Marie ; Linder, James ; Weisenburger, D. ; Harrington, D. ; Casey, J. ; Bierman, Philip Jay ; Sorensen, S. ; Hutchins, M. ; Moravec, D. F. ; Howe, D. ; Dowling, M. D. ; Mailliard, J. ; Johnson, P. S. ; Pevnick, W. ; Packard, W. M. ; Okerbloom, J. ; Thompson, R. F. ; Langdon, R. M. / Clinical significance of immunophenotype in diffuse aggressive non-Hodgkin's lymphoma. In: Journal of Clinical Oncology. 1989 ; Vol. 7, No. 12. pp. 1783-1790.
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AU - Casey, J.

AU - Bierman, Philip Jay

AU - Sorensen, S.

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N2 - We performed a prospective study of the clinical significance of immunophenotype in 110 patients with aggressive non-Hodgkin's lymphoma (NHL) treated by oncologists in the Nebraska Lymphoma Study Group between October 1982 and May 1986. All patients were immunophenotyped from biopsies performed before therapy was administered. The patients were treated with a uniform protocol of radiotherapy for minimal nonbulky, stage I or II disease (seven patients) or a single, six-drug chemotherapy regimen cyclophosphamide, doxorubicin, procarbazine, bleomycin, vincristine, and prednisone (CAP-BOP) in patients with more extensive disease (103 patients). Ninety-one patients (83%) had B-cell lymphoma and 19 patients (17%) had T-cell lymphoma. The histologic diagnosis of diffuse mixed-cell lymphoma was significantly associated with T-cell immunophenotype (45% v 5%; P < .001), and the diagnosis of diffuse large-cell lymphoma was significantly associated with B-cell immunophenotype (40% v 5%; P = .006). However, no significant difference in frequency of prognostic variables such as age, stage, systemic symptoms, tumor bulk, serum lactic dehydrogenase, or performance status was found between the B-cell and T-cell groups. Patients with B-cell NHL had a slightly higher complete remission rate (74% v 53%; P = NS), similar durability of complete remission (75% v 70% at 3 years; P = NS), and a slightly but not significantly better overall survival (50% v 41% at 3 years, P = NS). The slight advantage in response rate and survival for B-cell patients was related to a very poor outcome for patients with stage IV T-cell NHL. For patients with stage I to III disease, neither the complete remission rate (B-cell, 82% v T cell, 91%; P = NS) nor overall survival (3-year survival for B cell, 58% v T cell, 73%; P = NS) were significantly different. However, with stage IV disease B-cell patients fared far better than those with T-cell NHL for both complete remission rate (67% v 0%; P = .002) and overall survival (3-year survival, 44% v 0%; P = .002). Immunophenotyping intermediate- and high-grade NHL allowed identification of a subgroup of patients who had a very poor prognosis with this treatment approach and for whom alternate therapy might be considered.

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