DNA content and prognosis of non-Hodgkin's lymphoma

Morgan, Diana; Williamson, J. M. S.; Quirke, Philip; Clayden, A D; Smith, Mark E.; O'Brien, C J; Allison, D L; Child, J. A.; Bird, C. C.

doi:10.1038/bjc.1986.221

Cited by 45 publications

(22 citation statements)

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“…The problems associated with the histological classification of NHL are well recognised (NCI Non-Hodgkin's Lymphoma Classification Project Writing Committee, 1985), and reproducible quantitative methods of tumour classification are required to confer additional prognostic information to guide the clinician in the selection of the most appropriate therapeutic approach. FCM analysis represents a method for the rapid estimation of nuclear DNA content in tumour cell populations, providing information on the potentially important tumour parameters of DNA ploidy and proliferative activity.Previous FCM studies in NHL have suggested that both tumour cell proliferation and the incidence of DNA aneuploidy increase with progression from low to high grade histology (Scarffe & Crowther, 1981;Braylan et al, 1984;Srigley et al, 1985; Christensson et al, 1986;Morgan et al, 1986;Bauer et al, 1986;Juneja et al, 1986) …”

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“…Previous FCM studies in NHL have suggested that both tumour cell proliferation and the incidence of DNA aneuploidy increase with progression from low to high grade histology (Scarffe & Crowther, 1981;Braylan et al, 1984;Srigley et al, 1985;Christensson et al, 1986;Morgan et al, 1986;Bauer et al, 1986;Juneja et al, 1986) Table I, and the details of the treatment schedules have been outlined elsewhere (Steward et al, 1984;Wagstaff et al, 1987). In brief, 168 patients received initial chemotherapy using a weekly schedule of chemotherapy with VAP (vincristine, adriamycin, prednisolone).…”

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DNA content in high and intermediate grade non-Hodgkin's lymphoma-prognostic significance and clinicopathological correlations

Cowan

Harris²,

Jones³

et al. 1989

Br J Cancer

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Summary Flow cytometric (FCM) estimation of DNA content has been performed on tumour tissue from 197 patients with high and intermediate grade non-Hodgkin's lymphoma (NHL) to investigate the clinicopathological correlations and prognostic significance of DNA ploidy and proliferative activity. Fifty-one per cent of tumours were diploid; the remaining non-diploid tumours were near diploid (14%), aneuploid (28%) and tetraploid (7%). In 81 tumours multiple analyses were performed from different regions of the tumour, ploidy discrepancy was seen within the same tumour in 13/81 tumours (16%), and intra-tumour variation in proliferative index (PI) in 72 tumours was estimated at ± 5%. Ploidy status did not correlate with histological subtype (Kiel or Rappaport), Ann Arbor stage or the site of disease at presentation. There was no significant difference in response rate, relapse-free survival (RFS) or overall survival rate between the different ploidy categories. Tumour proliferative index (PI) varied markedly between patients (range 2-51%, median 14%). A significant association was observed between PI and histological subtype in the Kiel classification (P = 0.001). The median PI for the lymphoblastic lymphomas was 20% compared with 10% for the centrocytic tumours. An elevated PI was significantly associated with a reduced response rate (P = 0.023), with 71% of patients with a low PI (<20%) achieving complete remission (CR) compared with 49% patients with a high PI (>20%). Despite this correlation with CR, PI was not significantly associated with overall survival. When the DNA data was combined with over 20 other potential prognostic factors in multivariate analysis, ploidy and proliferative activity did not prove to be of independent prognostic significance for response, RFS or overall survival. In 20 patients additional biopsy material was available from the site of subsequent relapse. In these cases, although the histology at relapse remained unchanged, ploidy status altered in 13/20 patients, and there was a significant rise in tumour PI at relapse compared with the initial pre treatment biopsy (P = 0.017). We conclude that in high and intermediate grade NHL, DNA ploidy as assessed using conventional FCM analysis is not significantly associated with clinical outcome. However, proliferative activity does correlate with histological subtype and response to therapy, and this parameter warrants further evaluation in future studies.With the advent of intensive combination chemotherapy, durable remissions have been achieved in over 50% of patients with high grade NHL (Fisher et al., 1983;Connors & Klimo, 1988;Coleman et al., 1988). However, these patients comprise a heterogenous group with varied patterns of disease and differing clinical outcome. The problems associated with the histological classification of NHL are well recognised (NCI Non-Hodgkin's Lymphoma Classification Project Writing Committee, 1985), and reproducible quantitative methods of tumour classification are required to confer additional prognostic informa...

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DNA content in high and intermediate grade non-Hodgkin's lymphoma-prognostic significance and clinicopathological correlations

Cowan

Harris²,

Jones³

et al. 1989

Br J Cancer

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“…In most malignancies an abnormal DNA content -aneuploidy-has been found, and frequently it has been associated with an adverse prognosis: breast, urinary bladder, uterine cervix, ovary, colo-rectal and non-small cell lung tumors (12). In systemic non-Hodgkin lymphomas, there is no agreement concerning the prognostic value of FC (13)(14)(15)(16)(17). The published studies focusing on primary gastric lymphomas are scanty and also, the results concerning FC prognostic value are contradictory (11,12,(18)(19)(20).…”

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Prognostic value of flow cytometry in surgically treated primary gastric lymphoma

Fernández

Rodríguez‐Sanjuán

Mayorga

et al. 2006

Rev. esp. enferm. dig.

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Aim: to investigate whether flow cytometry could help to define the optimal therapeutic strategy of primary gastric lymphomas.Material and method: retrospective study of 46 patients having primary gastric lymphoma -according to Dawson criteria-in Ann Arbor stage I E and II E , who were surgically treated. From selected paraffin-embedded tissue blocks of the tumor, DNA content was studied by flow cytometry (FC). Other pathological tumor features were analysed by hematoxiline-eosine and Giemsa stains as well as immunohistochemical study; any possible influence on postoperative survival was investigated through statistical analysis.Results: the DNA ploidy pattern was diploid in 40 cases (87%) and aneuploid (hyperdiploid) in 6 (13%). Postoperative survival probability (PSP) was 62.7% at 5 years. Statistical analysis showed significant prognostic value for Ann Arbor classification -with higher PSP for stage I E (p = 0.009)-and FC parameters: diploid tumors had higher PSP than aneuploid tumors. Also tumors having S-phase (p = 0.044) or G2-M phase values (p = 0.023) under the respective mean values had higher PSP. No influence on PSP was found for wall invasion, Helicobacter pylori infection, Isaacson's histologic type or resection margin involvement. No significant relationship was appreciated between Isaacson's histologic type and DNA ploidy patterns.Conclusion: FC could be useful in assessing gastric lymphoma prognosis.

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“…It was in an attempt to reconcile the principal histopathological systems of classification and to recognise that there were more than two broad groupings within the non-Hodgkin's lymphomas that led to the consensus classification of the Working Formulation (The non-Hodgkin's lymphoma pathologic classification project, 1982 (Costa et al, 1981;Gerdes et al, 1984;Akerman et al, 1987). Measurement of DNA content by flow cytometry with determination of proliferation indices represents a further step in classifying NHL and predicting outcome (Diamond et al, 1982;Roos et al, 1985;Morgan et al, 1986;Williamson et al, 1987). Within particular categories, for example mixed centroblastic-centrocytic NHL, ploidy and proliferation index have shown correlation with prognosis (Griffin et al, 1988 While the majority of NHL are B cell in origin, both the immature and mature T cell diseases need to be characterised.…”

Section: Histopathological Classification and Pathological Variablesmentioning

confidence: 99%

Prognostic factors in the non-Hodgkin's lymphomas--a time for consensus?

Child¹

1991

Br J Cancer

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DNA content and prognosis of non-Hodgkin's lymphoma

Cited by 45 publications

References 14 publications

DNA content in high and intermediate grade non-Hodgkin's lymphoma-prognostic significance and clinicopathological correlations

DNA content in high and intermediate grade non-Hodgkin's lymphoma-prognostic significance and clinicopathological correlations

Prognostic value of flow cytometry in surgically treated primary gastric lymphoma

Prognostic factors in the non-Hodgkin's lymphomas--a time for consensus?

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