Principles and present status of a prospective multicenter study on the clinical relevance of the kiel classification

Brittinger, G; Schmalhorst, U.; Bartels, H.; Fülle, H. H.; Gerhartz, H.; Gremmel, G.; Grisar, Thierry; Grupp, Hans-Joachim; Gunzer, U; Huhn, D.; Koeppen, K.‐M.; Kubanek, B; Leopold, Howard C.; Löffler, Helmut; Löhr, G. W.; Nowicki, L.; Rühl, U; Schmidt, M.; Stacher, A; Theml, H; Lennert, K.

doi:10.1007/bf00363886

Cited by 34 publications

(6 citation statements)

References 29 publications

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“…These cases are identified.in Figure 2 and Table II: Myeloma, FCC cb/cc foll 'D', FCC cb/cc diff 'E'. This discrepancy has also been described in a previous study (Brittinger et al, 1981). The reliable determination of cases with a poor outcome very early could justify aggressive treatment in good histological sub-types of NHL.…”

Section: Specimenssupporting

confidence: 74%

“…The DNA was denatured by immersion for 2min in 0.07N NaOH, followed by the neutralisation of the base in 0.1 M borate buffer pH 8.5. Anti-BrdU (Grazner, 1982) was then applied for 30 min and visualised using the enhanced APAAP method (Cordell et al, 1984) Frozen sections (Figure 3a, Camplejohn & Macartney, 1985) and autoradiography (Costa et al, 1981a,b).…”

Section: Specimensmentioning

confidence: 99%

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A comparison of three methods for the determination of the growth fraction in non-Hodgkin's lymphoma

Schrape¹,

Jones²,

Wright³

1987

Br J Cancer

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Summary The proliferation rate of non-Hodgkin's lymphomas (NHL) was estimated by using 3 different methods. In cell suspension we determined the proportion of cells in cycle with the monoclonal antibody (Mab) Ki-67 and also in S-phase after the incorporation of bromo-deoxyruridine (BrdU) utilizing Mab antiBrdU. In low grade lymphomas 3.5 + 1.6% of the cells were in cycle and 1.2 + 0.9% in S-phase, the corresponding values for high grade lymphomas were 22.5 + 18.7% and 8.9 + 7.8% respectively.Frozen sections of NHL were reacted with an antibody to the transferrin receptor (TR) and Ki67 as markers for proliferative activity. A high number of TR positive cells was found in low grade lymphomas of all histological types, whereas Ki67 positivity correlated closely with grading. With a few exceptions, low grade lymphomas contained less than 25% Ki67 positive cells within the tumour cell population. This observation is relevant to treatment strategies for low grade NHL.Schemes for the histological classification of non-Hodgkin's lymphoma (NHL) are used to determine treatment strategies and to predict prognosis (Rosenberg et al., 1982). Recently, methods have been used to determine the proliferation rate in NHL, based on the measurement of transferrin receptor (TR) status (Habeshaw et al., 1983) thymidine uptake (Kvaloy et al., 1985; Costa et al., 1981a) or the determination of cells in S-phase by flow cytometry (Roos et al., 1985). The proliferating fraction in NHL may give additional valuable information relevant to therapy and prognosis.In this study we have compared various methods for the investigation of cells in cycle in NHL. TR status on frozen section has been compared with the monoclonal cell cycle marker Ki67 (Gerdes et al., 1984a, b) and on cell suspensions derived from biopsy material staining with Ki67 has been undertaken in parallel with the determination of S-phase using BrdU pre-incubation followed by staining with monoclonal anti-BrdU. We conclude that staining with Ki67 provides a convenient and reproducible method for cell cycle analysis which is easily included in routine monoclonal diagnostic profiles. Materials and methods SpecimensSixty fresh lymph node (LN) biopsies were obtained from the Southampton and South West Hampshire Health District. Fifty-four were subsequently diagnoses as NHL and 6 showed reactive changes only. The mean age of the patients with NHL was 60 years in both sexes, though males were twice as common as females in this group.One part of the biopsy was snap frozen in liquid nitrogen and stored at -198°C until required for immunohistologic phenotyping. A second part was fixed in formalin and processed for conventional hi'stologic examination. Histological type was assessed on this material and confirmed by immunostaining of frozen sections with an appropriate panel of monoclonal antibodies (Jones et al., 1986 The viability of mononuclear cell suspensions obtained by this method was always -90% when tested by trypan blue exclusion. The cell count was adjusted to 1 x 106 cells m...

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Section: Specimenssupporting

confidence: 74%

Section: Specimensmentioning

confidence: 99%

A comparison of three methods for the determination of the growth fraction in non-Hodgkin's lymphoma

Schrape¹,

Jones²,

Wright³

1987

Br J Cancer

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“…The survival of our patients appears to be similar to that of other reported series, both for high-and for low-grade malignant histologic subgroups [4,10,12,23]. We do not think that the treatment given to our patients influenced survival differently than did other therapies in other groups of patients [ 12,[24][25][26][27] , symptoms and bone marrow involvement [6]; (b) bul kiness of tumour, prior therapy, sex and lymphocyte count [7]; (c) haemoglobin concentration, treatment with adriamycin, sex, and prior therapy, for nodular types only [8]; (d) sex, symptoms, bone marrow in volvement and large gastrointestinal mass, in diffuse lymphomas only [10]; (e) histopathologic group and symptoms, with a number of minor humoral prognostic factors [12]; (0 achievement of complete remission, serum LDH level and presence or absence of liver involvement, in the high-grade histotypes only [13], where a high probability of achiev ing complete remission is given by the lack of B symptoms, absence of bone marrow involvement, high serum albumin and female sex.…”

Section: Discussionsupporting

confidence: 76%

“…Moreover, despite the relative complexity of all the classifications, until now histology has only been able to provide patients with a rough prognostic allo cation into either a merely high-or low-grade malig nant group or sometimes an intermediate one [4,5]. Experimental data on prognostic factors are fewer than those for Hodgkin's disease and often discordant or non-comparable [6][7][8][9][10][11][12][13].…”

Section: Introductionmentioning

confidence: 99%

Prognostic Factors in Non-Hodgkin’s Lymphomas

et al. 1985

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Prognostic factors were investigated in 67 patients with non-Hodgkin’s lymphomas, homogeneously staged and treated (COP or CHOP according to low or high malignant histotype). A large number of parameters were scrutinized in order to recognize those exhibiting a prognostic value regarding length of survival. All the parameters that singly appeared to influence survival were entered into a multiple regression factor analysis. The erythrocyte sedimentation rate (ESR), higher or lower than 35 mm at the 1st h, better discriminated the groups of patients surviving or not at a given time. The histologic type, according to the Kiel classification of malignancy, was the second best prognosticator when a short-term prediction was requested (survival or death after no more than 2.5 years), but showed insufficient statistical weight for predicting longer survivals ( > 4 years). Stage seemed to be the third best prognosticator for the first years of survival, but only the second best for longer survivals. Other parameters had very low prognostic importance when compared with those above. The results were substantially confirmed by 28 other patients, taken as controls. The importance that such a simple and easy test as ESR may be adequate with regard to prognosis is emphasized

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“…A simple division into two, or possibly three, categories (low, intermediate, and high grade malignancy) has been advocated, which, in principle, reflects tumours containing small cytic cells or large blastic cells, respectively. This simple classification has been of practical value as a predictor of prognosis and in the selection of proper treatment (7,20).…”

mentioning

confidence: 99%

An Attempt to Characterize Malignant Lymphoma in Spleen, Liver and Lymph Nodes with Magnetic Resonance Imaging

Nyman¹,

Rhen²,

Ericsson³

et al. 1987

Acta Radiol

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An attempt was made to explore whether relaxation times and/or normalized image intensities obtained from magnetic resonance imaging (MRI) can separate malignant and non-malignant lymphomatous tissue. Spin-echo (SE) techniques with repetition times of 500 and 1500 ms and echo times of 35 and 70 ms were used for estimating T I and T2. Estimation of T 1 and T2 with such a low number of spin-echo sequences resulted in considerable variation in the data especially when T 1 was long. Similar information was also extracted by normalizing the image intensities to the 'proton density' image (1500/35), and the spread of the data was then markedly reduced. Therefore, the method of normalizing was considered a more appropriate way of handling the image data when only a few sequences were available. No significant difference could be discerned in the MRI parameters between normal spleens and spleens infiltrated with malignant lymphoma, between normal livers and livers in patients with malignant lymphoma and between lymph nodes with low or high grade non-Hodgkin lymphoma. Lymphomatous tissue had similar MRI characteristics irrespectively of whether the cells were malignant or not, or located in spleens or in lymph nodes. The main biologic explanation for variation in data seems to be mostly the variable amounts of fibrosis, necrosis, oedema and/or iron content.

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Principles and present status of a prospective multicenter study on the clinical relevance of the kiel classification

Cited by 34 publications

References 29 publications

A comparison of three methods for the determination of the growth fraction in non-Hodgkin's lymphoma

A comparison of three methods for the determination of the growth fraction in non-Hodgkin's lymphoma

Prognostic Factors in Non-Hodgkin’s Lymphomas

An Attempt to Characterize Malignant Lymphoma in Spleen, Liver and Lymph Nodes with Magnetic Resonance Imaging

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