Survival of Patients With Localized Diffuse Histiocytic Lymphoma

• Published in: Blood Vol. 58; no. 6; pp. 1218 - 1223
• Main Authors: Sweet, Donald L., Kinzie, J., Gaeke, Mary Ellen, Golomb, Harvey M., Ferguson, Donald L., Ultmann, John E.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.12.1981
• Subjects: Actuarial Analysis; Female; Follow-Up Studies; Humans; Lymphoma - mortality; Lymphoma - pathology; Lymphoma - radiotherapy; Male; Neoplasm Staging; Time Factors
• ISSN: 0006-4971; 1528-0020
• DOI: 10.1182/blood.V58.6.1218.1218

Twenty-eight patients with previously untreated diffuse histiocytic lymphoma (DHL) were identified to be in pathologic stage (PS) I (11), IE (3), II (8), or IIE (6) by exploratory laparotomy and splenectomy. Six patients were treated with total nodal radiotherapy; 14 with an extended mantle; 5 with an inverted Y or whole abdomen; and 3 with an involved field. Twenty-six patients achieved a complete remission (93%) and 2 patients had persistent local disease. The median survival and disease-free survival and for the complete response group are 56 and 51.5 mo, respectively. Ten of the 11 stage I or IE patients had supradiaphragmatic lymph node disease. Patients with stage I or IE disease (n = 14) demonstrated a median survival of 72.5 mo and a median disease-free survival of 69.5 mo; there was 1 disease-related death. Patients with stage II or IIE disease (n = 14) demonstrated a median survival of 33 mo and median disease-free survival of 29.5 mo; there were 10 relapses or deaths. Patients in stages I, IE, II, or IIE with infradiaphragmatic disease (n = 7) had a median survival of 36 mo, while patients with supradiaphragmatic presentation (n = 21) demonstrated median survival of 68 mo (p = 0.37). The data indicate that patients with diffuse histiocytic lymphoma with stage I supradiaphragmatic lymph node disease are curable using radiotherapy alone, achieving a 93% 11-yr actuarial disease-free survival. Patients with stage II or IIE disease are not readily curable with radiation therapy alone, achieving a 33% 11-yr actuarial disease-free survival; radiotherapy with adjuvant chemotherapy or chemotherapy alone should be considered for this group.