Long term prognostic importance of primary Ki-1 (CD30) antigen expression and anaplastic morphology in adult patients with diffuse large-cell lymphoma

• Published in: Annals of oncology Vol. 5; no. 4; pp. 317 - 322
• Main Authors: Romaguera, J. E., Manning, J. T., Tornos, C. S., Rodriguez, J., Brooks, T. E., Pugh, W. C., Ordonez, N. G., Goodacre, A. M., Cabanillas, E.
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01.04.1994
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; anaplastic large cell lymphoma; Biological and medical sciences; Chromosome Aberrations - immunology; Chromosome Aberrations - pathology; Chromosome Disorders; Female; Follow-Up Studies; Genotype; Hematologic and hematopoietic diseases; Humans; Immunoenzyme Techniques; Ki-1 Antigen - analysis; Ki-1 lymphoma; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Lymphoma, Large-Cell, Anaplastic - mortality; Lymphoma, Large-Cell, Anaplastic - pathology; Male; Medical sciences; Middle Aged; Phenotype; Prognosis; Retrospective Studies; Skin Neoplasms - pathology; Survival Rate; Human; Prognosis; Lymphoproliferative syndrome; Morphology; Malignant hemopathy; Large cell lymphoma; Non Hodgkin lymphoma; Long term; Tumor cell
• ISSN: 0923-7534; 1569-8041
• DOI: 10.1093/oxfordjournals.annonc.a058833

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. Materials and 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.