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Mediastinal large-cell lymphoma with sclerosis (MLCLS)
A Z Rohatiner1, J S Whelan, R K Ganjoo
1ICRF Department of Medical Oncology, St Bartholomew's Hospital, West Smithfield, London, UK.
British Journal of Cancer
|March 1, 1994
Summary
Mediastinal large-cell lymphoma with sclerosis has a poor initial response rate to chemotherapy. However, some patients can achieve long-term remission, suggesting chemotherapy alone may be curative for a subset.
Area of Science:
- Oncology
- Hematology
- Pathology
Background:
- Mediastinal large-cell lymphoma with sclerosis is a rare subtype of high-grade B-cell lymphoma.
- Patients often present with bulky disease and superior vena cava obstruction.
Purpose of the Study:
- To evaluate the treatment outcomes and prognosis of patients with mediastinal large-cell lymphoma with sclerosis.
- To determine the efficacy of initial chemotherapy regimens and the impact of subsequent treatments.
Main Methods:
- Retrospective analysis of 22 patients diagnosed between 1978 and 1992.
- Review of clinical, pathological, and treatment data.
- Assessment of treatment response, remission status, and long-term follow-up.
Main Results:
- Complete remission (CR) was achieved in only 4/22 patients with initial adriamycin-containing chemotherapy.
- Overall response rate (including partial remission) was 68% (15/22).
- 10/22 patients remained well without progression at a median follow-up of 5.5 years; 7 patients with initial treatment failure died.
Conclusions:
- A proportion of patients with this lymphoma subtype may be cured by chemotherapy alone.
- Residual mediastinal mass after treatment does not necessarily indicate treatment failure.
- Initial chemotherapy failure portends a very grave prognosis.