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Do pathologic features predict prognosis in diffuse large B-cell lymphoma?
J F Vago1, D D Weisenburger, J O Armitage
1Department of Pathology, University of Nebraska Medical Center, Omaha 68105.
Hematologic Pathology
|January 1, 1987
Summary
Histologic type, surface immunoglobulin phenotype, and mitotic rate can predict clinical outcome in diffuse large B-cell lymphoma (DLBL). Patients with DLBL-O had better survival than DLBL-NC, and IgG phenotype and lower mitotic rates correlated with improved outcomes.
Area of Science:
- Hematology
- Oncology
- Immunology
Background:
- Diffuse large B-cell lymphoma (DLBL) is a heterogeneous non-Hodgkin lymphoma.
- Predictors of clinical outcome in DLBL require further elucidation.
Purpose of the Study:
- To investigate whether histologic subtype, surface immunoglobulin (Ig) phenotype, or mitotic rate predict clinical outcome in DLBL.
- To analyze survival rates based on these prognostic factors in uniformly treated patients.
Main Methods:
- Analysis of 47 immunologically confirmed DLBL cases.
- Subclassification of DLBL into noncleaved cell (DLBL-NC), immunoblastic (DLBL-IBL), and other follicular center cell (DLBL-O) types.
- Evaluation of surface Ig phenotype (IgM vs. IgG) and mitotic rate (per 10 high-power fields).
Main Results:
- DLBL-O showed significantly longer predicted two-year survival (82%) compared to DLBL-NC (35%; p=0.05).
- Patients with a surface IgG phenotype had significantly longer predicted two-year survival (80%) than those with IgM (0%; p=0.02).
- A mitotic rate <30 per 10 high-power fields correlated with significantly longer predicted two-year survival (68%) versus >=30 mitoses (28%; p=0.01).
Conclusions:
- Histologic type (DLBL-O), surface IgG phenotype, and a lower mitotic rate (<30) appear to be favorable prognostic indicators in DLBL.
- These preliminary findings suggest distinct prognostic subgroups within DLBL.
- Further studies with larger patient cohorts are needed for confirmation.