Prognostic implications of karyotype and morphology in patients with non‐Hodgkin's lymphoma

Clonal chromosome abnormalities were observed in 30 patients with non‐Hodgkin's lymphoma; the type of lymphoma was characterized on the basis of the International Working Formulation. The 30 patients were classified into five groups according to the chromosome abnormality. There were 8 patients with t(14;18), 3 with t(8;14), 7 with a translocation to the long arm of chromosome 3 (a 3q+ chromosome), 5 with near‐tetraptoidy, and 7 with other abnormalities. Among the 8 patients with t(14;18), 5 had follicular small cleaved‐cell lymphoma (FSC), I had follicular mixed cell lymphoma (FM), and 2 had diffuse large‐cell lymphoma (DL); the diagnosis in these 2 patients was based on extranodal tissue. All 3 patients with t(8;14) had DL and B‐cell markers. Except for I patient, all those with a 3q+ chromosome had DL; 4 of those who were tested had B‐cell or pre‐B‐cell markers. Four of the 5 patients with near‐tetraploidy had follicular mixed‐cell lymphoma, and 2 of the 7 patients with other abnormalities had T‐cell lymphoma. Thus, patients with a t(8;14), a 14q+ chromosome, or a 3q+ chromosome all tend to have diffuse large‐cell lymphoma, usually of the non‐cleaved type. On the other hand, our data suggest that patients with FSC generally have a t(14;18) whereas those with follicular and diffuse mixed small cleaved cells and large non‐cleaved cells have a different pattern with modal chromosome numbers in the tetraploid range. We added 17 previously reported patients to the 30 presented here and correlated the karyotype with survival. The 6 patients with near‐tetraploidy had the longest median survival, 69 months, the 15 patients with t(14;18) had the next longest, 48 months. The 4 patients with (8;14) had Che shortest urvival, 12 months, and the 9 with other abnormalities had the next shortest, 17 months. Intermediate survivals of 27 and 30 months were observed in patients with a 14q+ or a 3q+ chromosome, respectively. The median survival of thaw various categories differs and our data, thus, indicate that the karyotypic pattern of the malignant cell may be a significant independent prognostic feature influencing the survival of patients with non‐Hodgkin's lymphoma.