Diffuse small cleaved-cell lymphoma: a heterogeneous disease with distinct immunobiologic subsets.
OBJECTIVE
Diffuse small cleaved-cell lymphoma (DSCL) is a relatively uncommon non-hodgkin's lymphoma (NHL) in the United States and has not been the subject of recent in-depth study of factors predictive of outcome. It is unique among the NHL of intermediate grade because there is no evidence of a curable subset of patients. To investigate whether any laboratory data might predict outcome, we studied 33 cases collected during a 12-year period and correlated morphology, immunohistochemistry, and serum lactate dehydrogenase (LDH) with clinical data and outcome.


RESULTS
We found that proliferative rate (Ki-67), cell lineage (T v B cell), and serum LDH were associated with significant differences in survival. A Ki-67 value greater than or equal to 20% was associated with a median survival of 20 months compared with 80 months for lower values (P = .0002); patients with tumors of T-cell lineage had a median survival of 20 months compared with 40 months for those with B-cell neoplasms (P = .0143); and a serum LDH greater than 225 IU/L was associated with a median survival of 8 months compared with 40 months for lower LDH levels (P = .0004). Blastoid morphology was also linked to a trend toward poor outcome (P = .08). Neither a history of low-grade lymphoma nor the presence of residual immunologically detectable follicles influenced outcome (P = .93 and .97, respectively).


CONCLUSIONS
We conclude that high Ki-67, high LDH, and T-cell lineage each identify DSCL patients with poor outcome.
Leith
C P
CP
Department of Pathology, University of Arizona, Tucson.
Spier
C M
CM
Grogan
T M
TM
Gonzales
G
G
Rangel
C S
CS
Rybski
J A
JA
Matzner
M
M
Miller
T P
TP
D000328:Adult; D000368:Aged; D001402:B-Lymphocytes; D002455:Cell Division; D005260:Female; D006801:Humans; D016130:Immunophenotyping; D019394:Ki-67 Antigen; D007770:L-Lactate Dehydrogenase / Q000097:blood*; D016131:Lymphocyte Subsets; D008228:Lymphoma, Non-Hodgkin / Q000201:enzymology / Q000276:immunology / Q000401:mortality* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009687:Nuclear Proteins / Q000097:blood*; D011237:Predictive Value of Tests; D011379:Prognosis; D016019:Survival Analysis; D013601:T-Lymphocytes
D019394:Ki-67 Antigen; D009687:Nuclear Proteins; D007770:L-Lactate Dehydrogenase