Survival in localized nodal and extranodal non-Hodgkin's lymphomata

A retrospective analysis of 133 patients with localized nodal and extranodal non-Hodgkin's lymphomata whose staging investigations included marrow aspirate and lymphography shows that more than 60% remain alive and disease-free 4 years after initial therapy. Further relapses may occur in this group, particularly in the nodular lymphomata, but so far the majority of relapses and three quarters of the deaths from disease have occurred within 2 years of diagnosis. Of the entire group of patients, only 15% showed an unequivocally nodular pattern and a further 25% a partially nodular, partially diffuse pattern. Thus, 60% of patients had diffuse lymphoma but differences were observed depending upon the site of presentation. In the nodal Stages I and II cases, whereas only 4 of 55 patients with supradiaphragmatic disease showed a nodular pattern, 12 of 24 infradiaphragmatic presentations had nodular lymphoma. This difference was reflected in a lower relapse rate in the latter group. Mediastinal involvement was uncommon but carried a grave prognosis. As far as it was possible to judge, extension to adjacent nodal areas as a cause of relapse was not a common problem and, as observed previously, relapse was much commoner to a wide variety of extranodal sites than is the case with Hodgkin's disease. In this series marrow involvement was documented in only 7 patients but this surprisingly low frequency might be due in part to infrequent marrow sampling after the initial investigations were completed.