Background and Objective. Although in recent years anaplastic large-cell lymphoma (ALCL) has emerged as a distinct clinlco-pathological entity, a gold standard for treatment has still not been defined. Goals of our histologic, phenotypic and clinical study were to present clinical findings, treatment outcome and survival rates of a small, but highly homogeneously treat ed, series of patients. Design and Methods. From April 1991, 36 newly diagnosed adult patients with systemic ALCL CD30(+), entered a prospective non-randomized trial in one of the institutions participating in a GISL (Gruppo Italiano per lo studio dei Linfomi) study and were treated with a MOPP/EBV/CAD hybrid scheme. Chemotherapy (CHT) was administered every 28 days, for a total of 6 cycles. After CHT, 19 patients received radiation therapy (RT) to the site of previously involved fields. Kaplan and Meier and log-rank tests were used for statistical analysis. Results. The overall complete remission rate was 78%, the partial remission rate was 6%. The overall survival rate at 74 months was 69%. No statistically significant differences in response or survival rates were noted comparing ALCL-HL and -CT subgroups, T+ Null- and B- subtypes, or ALCL-HL and -CT, with different phenotypes. In the analysis of patients with T+ Null phenotype treated with CHT+RT in comparison with B-ALCL patients who had the same treatment, we observed statistically significant differences in the survival rate (p=0.048). No prognostic factors predictive of response or survival were identified. Interpretation and Conclusions. Our results show that using MOPP/ABV/CAD the results, in terms of remission rate and survival, are similar to those obtained with 3(rd) generation CHT regimens. The diagnosis of T and Null ALCL is the mast important prognostic factor, because it Is associated with a very good survival, even in patients with a high prognostic index. Finally, we believe that longer follow-ups are needed to evaluate long-term survival and toxicity with different treatments. (C)1999, Ferrata Storti Foundation.
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|Data di pubblicazione:||1999|
|Titolo:||Clinical characteristics, treatment outcome and survival of 36 adult patients with primary anaplastic large cell lymphoma. Gruppo Italiano per lo Studio dei Linfomi (GISL).|
|Autori:||G. Longo; C. Fiorani; S. Sacchi; V. Callea; M. Lombardo; M. Federico; C. Stelitano; F. Angrilli; D. Vallisa; P.G. Gobbi; F. Ilariucci; A. Frassoldati; M. Petrini; V. Silingardi|
|Autori interni:||SACCHI, Stefano |
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