High-grade mature B-cell lymphoma with Burkitt-like morphology: results of a clinicopathological study of 72 Japanese patients.
The aim of the present study was to estimate optimum chemotherapeutic regimens for high-grade mature B-cell lymphoma cases with Burkitt-like morphology (Burkitt's lymphoma [BL]/Burkitt-like lymphoma [BLL]) patients. We analyzed 72 BL/BLL, including 36 with the c-myc translocation (molecular BL [mBL]), 20 without it (mBL-like), and 16 in whom we were uncertain regarding the existence of the c-myc translocation, and compared them with 182 diffuse large B-cell lymphoma (DLBCL) cases. On clinical and immunophenotypic analysis, the typical BL immunophenotype (CD10 positive, bcl-2 negative, and Ki-67 index >or=95%) was noted in 23 (66%) and 11 (55%) of the 35 mBL and 20 mBL-like patients, respectively. The presence of the c-myc translocation and typical immunophenotype in BL did not affect the overall survival of BL/BLL. There were no significant differences between the overall survival of DLBCL (45%) and BL/BLL (50%, P = 0.85). However, the overall survival of BL/BLL patients who received cyclophosphamide, doxorubicin, vincristine, and prednisolone-related therapy (22%) was significantly lower than that of DLBCL patients (P = 0.01). In contrast, the overall survival of BL/BLL patients who received aggressive short-term chemotherapy (75%) was better than that of the patients who received cyclophosphamide, doxorubicin, vincristine, and prednisolone therapy (P < 0.01). The finding was confirmed by multivariate analysis (hazard ratio 4.4; confidence interval 2.0-9.7; P = 0.0003). We concluded that aggressive short-term chemotherapy improves survival in BL/BLL, regardless of its genetic and immunophenotypic features.
Nomura
Yuko
Y
Department of Pathology, School of Medicine, Kurume University, Asahimati 67, Kurume 830-0011, Japan. yuko-nomura@mvj.biglobe.ne.jp
Karube
Kennosuke
K
Suzuki
Ritsuro
R
Ying
Guo
G
Takeshita
Morishige
M
Hirose
Shinichi
S
Nakamura
Shigeo
S
Yoshino
Tadashi
T
Kikuchi
Masahiro
M
Ohshima
Koichi
K
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002051:Burkitt Lymphoma / Q000175:diagnosis / Q000473:pathology; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D016130:Immunophenotyping; D007564:Japan; D016393:Lymphoma, B-Cell / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality* / Q000473:pathology; D016403:Lymphoma, Large B-Cell, Diffuse / Q000175:diagnosis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate