Premium
Biologic progression in non‐Hodgkin's lymphoma a flow cytometric study
Author(s) -
Joensuu Heikki,
Klemi Pekka J.,
Jalkanen Sirpa
Publication year - 1990
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19900601)65:11<2564::aid-cncr2820651128>3.0.co;2-p
Subject(s) - medicine , lymphoma , biopsy , working formulation , non hodgkin's lymphoma , pathology , large cell , gastroenterology , cancer , adenocarcinoma
The nuclear DNA content of 37 primary non‐Hodgkin's lymphomas both at presentation and at relapse was determined by flow cytometric analysis from paraffin‐embedded tissue to investigate changes in DNA ploidy and S‐phase fraction (SPF) during the course of the disease, and their association with survival. The repeat biopsies were done from 5 months to 15 years after the diagnosis. Four low‐grade lymphomas according to the Working Formulation transformed into intermediate‐grade lymphomas (four of 11, 36%), and four intermediate‐grade lymphomas into high‐grade lymphomas during the follow‐up (four of 16, 25%), and five of these eight transformed lymphomas were fatal within 18 months after relapse. The SPF correlated strongly with poor prognosis if measured either from the primary biopsy ( P = 0.008), the first ( P = 0.009), or the latest repeat biopsy ( P = 0.006). If SPF was ≥ 6% larger in a repeat biopsy than at presentation prognosis was poor; six of nine such patients died from lymphoma within 11 months from recurrence. An increase of ≥ 6% in the SPF was more common in high‐grade (four of nine, 44%) and intermediate‐grade (four of 16, 25%) lymphomas than in low‐grade lymphomas (one of 11, 9%), and it was occasionally (three of nine) associated with a morphologic change. In a few cases a repeat biopsy was diploid despite DNA aneuploidy at presentation. In conclusion, the study provides evidence that not only may low‐grade lymphomas transform into higher grade lymphomas, but high‐grade lymphomas may also frequently transform into more malignant forms during the course of the disease. The SPF is useful in monitoring the biological behavior of non‐Hodgkin's lymphoma, and it appears to give information not obtained by histologic study alone.