RESUMO
Determination of proliferative activity of non-Hodgkin's lymphomas (NHL), aimed at improving the prediction of their clinical behavior, has gained considerable attention in the recent years. Flow cytometry has allowed rapid measurement of the cellular DNA content in terms of ploidy and proliferative activity. Flow cytometric DNA analysis was performed on paraffin embedded biopsy specimens taken from 125 patients with NHL. In 90 of them, proliferative index (PI) could be accurately measured and correlated with histology grade of the Working Formulation (WF). Intermediate and high grade NHL (54 patients) were analyzed together as HG-NHL. With the discrimination point for PI of 10%, the survival of high and low proliferative lymphomas was compared in the whole NHL group and within the WF prognostic groups. The median PI was 5% in LG (low grade) NHL and 10% in HG (high grade) NHL group. Acturial survival in NHL with high proliferative activity (39 patients) was 31% at 5 years and 15% at 10 years, and in NHL with low proliferative activity (51 patients) 53% and 18%, respectively (p = 0.002). In HG-NHL, survival at 5 years for low proliferative cases was 55% and for high proliferative cases 28% (p = 0.065), whereas in the LG-NHL group it was 54% and 28%, respectively (p = 0.059). The survival at 10 years was nearly equal in all groups. Proliferative index was associated with the overall survival of NHL in the whole group, as well as within the LG and HG prognostic categories. PI could differentiate more and less aggressive NHLs both within LG-NHL and HG-NHL. A tendency of survival curves toward continuous relapse was observed in low proliferative NHL and a tendency toward "plateau" in high proliferative NHL, irrespective of the histology grade.
Assuntos
Linfoma não Hodgkin/patologia , Ciclo Celular/fisiologia , Feminino , Citometria de Fluxo , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prognóstico , Análise de SobrevidaRESUMO
In a group of 73 patients with low-grade non-Hodgkin's lymphomas (LG NHL) a multivariate analysis of the following variables was performed: pathological types following the International Working Formulation, clinical stage, B-symptoms, erythrocyte sedimentation rate, hemoglobin level, white blood cell and lymphocyte count, serum gamma globulin level, serum total lactic dehydrogenase (LDH) level, mitotic and complete remission. The patients with lymphocytic lymphoma manifested the best survival in this group. Low-proliferative lymphomas showed better survival than high-proliferative lymphomas at 3 and 10 years. B-symptoms, serum total LDH level and complete remission were significant independent prognostic factors.
Assuntos
Linfoma não Hodgkin/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Sedimentação Sanguínea , Divisão Celular , Progressão da Doença , Intervalo Livre de Doença , Hemoglobinas/análise , Humanos , L-Lactato Desidrogenase/sangue , Leucemia Linfocítica Crônica de Células B/diagnóstico , Leucemia Linfocítica Crônica de Células B/mortalidade , Contagem de Leucócitos , Linfoma não Hodgkin/sangue , Linfoma não Hodgkin/mortalidade , Pessoa de Meia-Idade , Mitose , Análise Multivariada , Prognóstico , Estudos RetrospectivosRESUMO
The incidence of aneuploidy was determined by flow cytometric analysis in paraffin-embedded tumor samples of 125 patients with non-Hodgkin lymphoma (NHL). There were 48 low-grade (LG) and 77 high-grade (HG) tumors. Aneuploidy was found in 34 (27%) NHL, 15 (31%) LG, and 19 (25%) HG tumors. The analysis of patient survival showed a significantly better survival of patients with LG than HG NHL, but the presence of aneuploidy did not influence the survival on the level of all patients, patients with LG or patients with HG NHL. In patients with LG NHL a tendency of diploid vs. aneuploid patients to survive longer was observed, but only at P = 0.056 significance level.