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The prognostic significance of the immunotype in diffuse large-cell
lymphoma: a comparative study of the T-cell and B-cell phenotype
SM Lippman, TP Miller, CM Spier, DJ Slymen and TM Grogan
Department of Internal Medicine, Arizona Cancer Center, Tucson 85724.
The clinical significance of immunophenotyping of the non-Hodgkin's
lymphomas is controversial. Therefore, we conducted the present study of
103 consecutively accrued diffuse large-cell lymphoma (DLCL) patients to
define, independently of histologic subtypes, the prognostic importance of
phenotyping. We used an extensive panel of monoclonal antibodies to T- and
B-cell antigens to assign all patients immunologically into the T-cell (20
patients) or B-cell group (83 patients). The only significant differences
in pretreatment clinical variables between the two patient groups were the
higher frequency of bulky disease (greater than 10 cm) in B-cell patients
(P = .008) and more frequent skin involvement in the T-cell group (P less
than or equal to .001). Multiagent doxorubicin-containing chemotherapy
regimens were employed as initial therapy in over 83% of the patients in
each group. Our study revealed that disease-free survival (DFS) was
significantly shorter in the T-cell patients than in the B-cell DLCL
patients (median DFS, 10.8 months for T-cell and 42.7 months for B- cell; P
= .01, log rank). No patient with T-cell DLCL remained disease free for
longer than 2 years, whereas 55% of the B-cell group were disease free at 2
years. Univariate and multivariate analyses of all major prognostic factors
of DFS suggest that the T-cell phenotype indicates an incurable subset of
DLCL patients. Although the B-cell group had a twofold advantage in median
survival (35 months v 18 months), actuarial overall survival was not
significantly different between the two patient groups (P = .23). Our
results indicate the need for new approaches in the search for a curative
treatment for T-cell DLCL.
Volume 72,
Issue 2,
pp. 436-441,
08/01/1988
Copyright © 1988 by The American Society of Hematology
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