Non-hodgkin's lymphoma, poorly differentiated lymphocytic and mixed cell types.Results of sequential staging procedures, response to therapy, and survival of 100 patients

Abstract

The results of sequential staging procedures including laparotomy, radiotherapy, and combination chemotherapy are reported for 100 patients with poorly differentiated lymphocytic (PDL) and mixed cell (M€) non-Hodgkin's lymphoma (NHL). Twelve patients were found to have localized disease, pathologic stage (PS) I or 11; 88 patients had PS I11 or IV disease. Bone marrow biopsy showed a high incidence of involvement and advanced 34% of the patients from CS I, 11, and I11 to PS IV. Staging laparotomy has a very limited role in the evaluation of these patients. All of 12 patients with PS I and I1 NHL were treated with radiotherapy; at 5 years, they had 100% survival, 80% being disease-free. Fifteen patients with PS I11 disease were treated with total nodal radiotherapy (TNRT) alone and had a median diseasefree survival of 41 months. The remaining patients with PS I11 and IV disease were treated with chemotherapy consisting of vincristine afid prednisone (V 8c P); cyclophosphamide, vincristine (Oncovin@), procarbazine, and prednisone (COPP); cyclophosphamide, vincristine (Oncovin@), adriamycin, and prednisone (COPA); or "palliative therapy", consisting of chlorambucil and prednisone. Two-year and 4-year survivals for patients with diffuse lymphoma were 93% and SO%, respectively; for patients with +2 nodular lymphoma, 80% and 30%; for patients with nodular lymphomas, 76-93% and 5076, respectively. Treatment with COPP showed no advantage over V and P, "palliative therapy," or TNRT for patients with +2 nodular and nodular disease. The likelihood of cure appears most promising for patients in complete remission (CR) with diffuse lymphoma; patients in CR with nodular lymphoma show a high rate of relapse over 5 years of observation.We conclude that staging laparotomy in PDL and MC NHL is of limited value, and that the role of aggressive chemotherapy for patients with +2 nodular and nodular lymphoma needs to be redefined.Cancer 42:88-95, 1978. HE NON-HODGKIN'S LYMPHOMAS (NHL) cancer-related deaths in the United Statesz3T are the fifth most common cause of The clinical approach to be used by the

Management of stage I–II diffuse aggressive non‐hodgkin's lymphoma of the waldeyer's ring: Combined modality therapy versus radiotherapy alone

“…As none of our patients had staging laparotomy and not all of them had barium studies and CAT of abdomen, it remained possible that some of them might have more advanced disease on initial presentation. The question of staging laparotomy for non-Hodgkin's lymphoma has always been controversial, as it is not without morbidity and mortality (Bitran et al, 1978;Chabner et al, 1977;Goffinet et al, 1977;Toonkel er al., 1980). Early relapses in clinically stage I and I1 diseases might have been due to missed lesions in the abdomen.…”

The Non-Hodgkin's Lymphomas

“…Four bone core biopsies, two obtained through a single skin incision from each posterior iliac crest, increase the di agnostic yield of this procedure. 10 The patient is a 69-year old man presenting with intermittent epigastric pain, anorexia, and a small bowel obstruction.…”

Εξωλεμφαδενικα Μη-Hodgkin's Λεμφωματα. Συχνοτητα-Κλινικοεργαστηριακη Αναλυση-Προγνωστικοι Παραγοντες. Συγκριση Με Τα Λεμφαδενικα Μη-Hodgkin's Λεμφωματα

“…Από το υπόλοιπο 20%, που με τη λεμφαγγειογραφία έχει σταδιοποιηθεί ως στάδιο Ι και II, στο 61% των οζωδών και στο 22,5% των διάχυτων λεμφωμάτων ανευρίσκεται κοιλιακή νόσος μετά τη λαπαροτομία [82]. Με αυτά τα δεδομένα, τα αληθώς τοπικά ΜΗΛ είναι πολύ λίγα σε αριθμό, λόγος για τον οποίον όπως φαίνεται, η εφαρμογή της λαπαροτομίας σ'αυτά τα λεμφώματα έχει εγκαταλειφθεί [83,84].…”