Evaluation of the Revised European-American Lymphoma Classification Confirms the Clinical Relevance of Immunophenotype in 560 Cases of Aggressive Non-Hodgkin's Lymphoma

摘要: The Revised European-American Lymphoma (REAL) classification has been criticized for its emphasis on the unproven clinical relevance of immunophenotype. A worse prognosis peripheral T-cell non-Hodgkin's lymphomas (PTCLs) inconsistently reported in part because definition PTCL imprecise (eg, T-cell–rich B-cell [TCRBCLs] have misdiagnosed as PTCLs past) and correlation with other known prognostic factors not studied by multivariate analysis. We analyzed six protocols from 1984 to 1995 Working Formulation intermediate grade immunoblastic (exclusive mantle cell) selected only those cases which immunophenotyping was performed conclusive. Of a total 560 evaluable patients, 68 were (12%) remaining 492 (88%) lymphomas, including 16 TCRBCLs (3% total). 5-year failure-free survival (FFS) large-cell (BCLCLs) is 38% 55%, respectively ( P < .0001) overall (OS) 39% 262%, .001). M.D. Anderson tumor score (MDATS) International Prognostic Index (IPI) all patients calculated. With MDATS less than 3 (good prognosis), FFS BCLCL 56% 69%, = .01), OS 64% 77%, .06). greater 2 (poor 26% 38%, .03), 24% 41%, .02). an IPI 49% 64%, .001), 55% 71%, .013). 11% 35%, .044), 10% 40%, .011). Multivariate analysis shows that MDATS, IPI, phenotype are totally independent most significant predictors OS. include 45 unspecified, 10 Ki-1 anaplastic (ALCL), 8 angioimmunoblastic, 5 angiocentric lymphomas. Angiocentrics usually refractory (1 remissions only). ALCL rarely relapsed late. conclude immunophenotypic basis REAL clinically relevant that, although features also influence outcome, still remains factor.