[Risk-adapted treatment of immunocytomas]

For 176 patients seen between 1976 and 1984, with a mean age of 65 years, the probability of survival after ten years was 56% for lymphoplasmocytoid (n = 86), lymphoplasmocytic (n = 38) and non-classifiable (n = 10) subtypes, while it was 0% at the end of 6.5 years for the polymorph cell type (n = 42). Patients up to 60 years of age had, at 68%, a generally better prognosis than older ones, at only 30%. Cases with bone-marrow infiltration or leukemic washout (n = 114) were, like chronic lymphoid leukemia cases, classified according to the scheme of Rai and co-workers, while the remaining cases (n = 62) were classified according to the Ann Arbor scheme. There was a three-step prognosis of ten-year probability of 85% for stages I A, Rai 0, Rai I (n = 49), 50% for II A/B, III A, Rai II (n = 43), and 27% for III B/IV B and Rai III/IV (n = 41) of the non-polymorph cell subtypes. For the polymorph cell forms there was also a triple division with 88%, 53% and 14% after only four years. Additional unfavorable factors were rapid lymphoma growth, leukemic course, high paraprotein gradient and autoimmune hemolysis. The flexible employment of polychemotherapy and large-field radiotherapy, adapted to the mentioned unfavorable risk factors and age, contributed to the improved results in this heterogeneous group.