title: Long-term prognostic importance of primary Ki-1 (CD30) antigen expression and anaplastic morphology in adult patients with diffuse large-cell lymphoma.
abstract: BACKGROUND
  We retrospectively assessed the long-term prognostic importance of primary CD30 antigen expression and of anaplastic large-cell morphology (ALCL) in adult patients with previously untreated diffuse large-cell lymphoma (DLCL), including cases of immunoblastic lymphoma, and identified their clinical features.
  
  
  METHODS
  We examined available archival paraffin-embedded or frozen pathologic material and medical records of adult patients with previously untreated DLCL seen at M.D. Anderson Cancer Center (MDACC) between January 1978 and May 1989.
  
  
  RESULTS
  Sixty-seven cases of DLCL and seven cases of IBL (a total of seventy-four heretofore referred to as DLCL) were identified. Twenty-two of the 74 patients were positive for the CD 30 antigen. For these 22 patients the rates of complete remission, survival, and time to treatment failure (TTF) were 86%, 82%, and 77%, respectively, at 81 months. When compared with the group of 54 patients which stained negative for CD 30, the long term survival of CD 30-positive DLCL was favorable (82% vs. 49%, p = 0.08). ALCL morphology was present in two-thirds of the patients with CD 30-positive DLCL but did not affect survival and TTF rates. Among patients with CD 30-positive DLCL, 16 patients without skin involvement were younger and had a low failure rate (13%) compared with six patients with skin involvement who were older and had a high failure rate (50%); however, the latter group had a more indolent course after failure and thus both groups had similar survival rates.
  
  
  CONCLUSIONS
  Primary CD 30 positivity is associated with a favorable long-term prognosis in adult patients with DLCL treated with doxorubicin-containing chemotherapy. ALCL morphology among these patients does not affect the outcome. Patients with CD30-positive DLCL and skin involvement have a higher failure rate than those without skin involvement, but similar overall survival.
authors.affiliation: Department of Hematology, University of Texas, M.D. Anderson Cancer Center, Houston.
authors.forename: J E
authors.initials: JE
authors.lastname: Romaguera
authors.forename: J T
authors.initials: JT
authors.lastname: Manning
authors.forename: C S
authors.initials: CS
authors.lastname: Tornos
authors.forename: J
authors.initials: J
authors.lastname: Rodriguez
authors.forename: T E
authors.initials: TE
authors.lastname: Brooks
authors.forename: W C
authors.initials: WC
authors.lastname: Pugh
authors.forename: N G
authors.initials: NG
authors.lastname: Ordonez
authors.forename: A M
authors.initials: AM
authors.lastname: Goodacre
authors.forename: F
authors.initials: F
authors.lastname: Cabanillas
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002869:Chromosome Aberrations / Q000276:immunology / Q000473:pathology; D025063:Chromosome Disorders; D005260:Female; D005500:Follow-Up Studies; D005838:Genotype; D006801:Humans; D007124:Immunoenzyme Techniques; D017730:Ki-1 Antigen / Q000032:analysis*; D017728:Lymphoma, Large-Cell, Anaplastic / Q000401:mortality / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D010641:Phenotype; D011379:Prognosis; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000473:pathology; D015996:Survival Rate
chemical_list: D017730:Ki-1 Antigen