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CB/CC diffuse lymphoma: a distinct subtype of non-Hodgkin's lymphoma? A study of 1593 patients from a Danish
L Munksgaard1, B E Christensen, H Brincker
1Department of Hematology, Odense University Hospital, Denmark.
Insights
The rare CB/CC diffuse non-Hodgkin
Area of Science:
- Hematology
- Oncology
- Pathology
Background:
- The Kiel classification identified CB/CC diffuse as a subtype of non-Hodgkin's lymphoma (NHL).
- The European-American consensus classification (REAL, 1994) provisionally categorized CB/CC diffuse lymphoma.
- Previous analysis indicated shorter survival for CB/CC diffuse compared to CB/CC follicular subtypes.
Purpose of the Study:
- To investigate clinical differences between CB/CC diffuse lymphoma and other NHL subtypes.
- To determine if CB/CC diffuse lymphoma possesses a distinct clinical phenotype.
Main Methods:
- Analysis of clinical parameters at presentation in a subset of NHL cases.
- Inclusion of 148 CB/CC diffuse cases and 971 cases from four other subtypes (CB/CC follicular, CB diffuse, CC diffuse, peripheral T-cell lymphoma).
- Logistic regression analysis to compare clinical characteristics.
Main Results:
- Significant differences were observed in sex ratio, age distribution, and nodal/extranodal involvement sites between CB/CC diffuse and other NHL subtypes.
- CB/CC diffuse lymphoma demonstrated a distinct clinical presentation compared to CB/CC follicular, CB diffuse, CC diffuse, and peripheral T-cell lymphoma.
Conclusions:
- CB/CC diffuse lymphoma exhibits a distinct clinical phenotype.
- These findings suggest underlying biological differences between CB/CC diffuse and other NHL subtypes.
Abstract:
Between 1983 and 1993, 3165 cases of non-Hodgkin's lymphoma (NHL) were reported to the West Danish Lymphoma Registry (LYFO). Out of these, 148 (4.7%) were of the CB/CC diffuse subtype according to the Kiel classification. However, in the new European-American NHL consensus classification (REAL, 1994), CB/CC diffuse lymphoma was categorized as a provisional subtype only. In the LYFO material, death-probability curves show a significantly shorter survival in CB/CC diffuse than in CB/CC follicular. In order to detect further possible differences between CB/CC diffuse and other NHL subtypes, a number of clinical parameters at presentation were analyzed in a subset of five types of lymphoma. This subset included 148 cases of CB/CC diffuse, 435 cases of CB/CC follicular, 667 cases of CB diffuse, 202 cases of CC diffuse, and 131 cases of peripheral T-cell lymphoma. Using logistic regression analysis, significant differences could be demonstrated between CB/CC diffuse and the four other subtypes as regards sex ratio, age distribution, and sites of both nodal and extranodal involvement. These findings indicate that CB/CC diffuse has a distinct clinical phenotype and imply the existence of real biological differences between CB/CC diffuse and other subtypes of lymphoma.