BACKGROUND\nAlthough many patients with intermediate-grade or high-grade (aggressive) non-Hodgkin's lymphoma are cured by combination chemotherapy, the remainder are not cured and ultimately die of their disease. The Ann Arbor classification, used to determine the stage of this disease, does not consistently distinguish between patients with different long-term prognoses. This project was undertaken to develop a model for predicting outcome in patients with aggressive non-Hodgkin's lymphoma on the basis of the patients' clinical characteristics before treatment.\n\n\nMETHODS\nAdults with aggressive non-Hodgkin's lymphoma from 16 institutions and cooperative groups in the United States, Europe, and Canada who were treated between 1982 and 1987 with combination-chemotherapy regimens containing doxorubicin were evaluated for clinical features predictive of overall survival and relapse-free survival. Features that remained independently significant in step-down regression analyses of survival were incorporated into models that identified groups of patients of all ages and groups of patients no more than 60 years old with different risks of death.\n\n\nRESULTS\nIn 2031 patients of all ages, our model, based on age, tumor stage, serum lactate dehydrogenase concentration, performance status, and number of extranodal disease sites, identified four risk groups with predicted five-year survival rates of 73 percent, 51 percent, 43 percent, and 26 percent. In 1274 patients 60 or younger, an age-adjusted model based on tumor stage, lactate dehydrogenase level, and performance status identified four risk groups with predicted five-year survival rates of 83 percent, 69 percent, 46 percent, and 32 percent. In both models, the increased risk of death was due to both a lower rate of complete responses and a higher rate of relapse from complete response. These two indexes, called the international index and the age-adjusted international index, were significantly more accurate than the Ann Arbor classification in predicting long-term survival.\n\n\nCONCLUSIONS\nThe international index and the age-adjusted international index should be used in the design of future therapeutic trials in patients with aggressive non-Hodgkin's lymphoma and in the selection of appropriate therapeutic approaches for individual patients.

A predictive model for aggressive non-Hodgkin's lymphoma

A revised European-American classification of lymphoid neoplasms: a proposal from the International Lymphoma study group

Purpose Peripheral T-cell lymphoma (PTCL) and natural killer/T-cell lymphoma (NKTCL) are rare and heterogeneous forms of non-Hodgkin’s lymphoma (NHL) that, in general, are associated with a poor clinical outcome. Patients and Methods A cohort of 1,314 cases of PTCL and NKTCL was organized from 22 centers worldwide, consisting of patients with previously untreated PTCL or NKTCL who were diagnosed between 1990 and 2002. Tissue biopsies, immunophenotypic markers, molecular genetic studies, and clinical information from consecutive patients at each site were reviewed by panels of four expert hematopathologists and classified according to the WHO classification. Results A diagnosis of PTCL or NKTCL was confirmed in 1,153 (87.8%) of the cases. The most common subtypes were PTCL not otherwise specified (NOS; 25.9%), angioimmunoblastic type (18.5%), NKTCL (10.4%), and adult T-cell leukemia/lymphoma (ATLL; 9.6%). Misclassification occurred in 10.4% of the cases including Hodgkin’s lymphoma (3%), B-cell lymphoma (1.4%), unclassifiable lymphoma (2.8%), or a diagnosis other than lymphoma (2.3%). We found marked variation in the frequency of the various subtypes by geographic region. The use of an anthracycline-containing regimen was not associated with an improved outcome in PTCL-NOS or angioimmunoblastic type, but was associated with an improved outcome in anaplastic large-cell lymphoma, ALK positive. Conclusion The WHO classification is useful for defining subtypes of PTCL and NKTCL. However, expert hematopathology review is important for accurate diagnosis. The clinical outcome for patients with most of these lymphoma subtypes is poor with standard therapies, and novel agents and new modalities are needed to improve survival. J Clin Oncol 26:4124-4130. © 2008 by American Society of Clinical Oncology

International peripheral T-cell and natural killer/T-cell lymphoma study: pathology findings and clinical outcomes.

Increasing knowledge about the biology of the non-Hodgkin's lymphomas has led to new approaches in classification. Rather than grouping lymphomas simply based on cell size, cell shape, and growth pattern, it is now possible to identify distinctive clinicopathologic entities. In many cases, the existence of specific immunologic and/or genetic features has confirmed the existence of these distinctive types of lymphoma. Since patients will be given these diagnoses by pathologists, it is important that clinicians be knowledgeable with regard to their clinical characteristics. The findings for the 13 most common lymphoma types that will be encountered in clinical practice are presented here.

New approach to classifying non-Hodgkin's lymphomas: clinical features of the major histologic subtypes. Non-Hodgkin's Lymphoma Classification Project.

The Armed Forces Institute of Pathology.

Malignant Lymphomas Other than Hodgkin’s Disease

Summary. 

It has been possible to reinterpret non-Hodgkin's lymphomas by applying subtle histological, cytological, and cytochemical techniques and electron microscopy as well as by using modern immunological methods and immune chemical analyses. This has led to the differentiation of four main groups of low-grade and three main groups of high-grade malignant lymphomas. Most non-Hodgkin's lymphomas are derived from the B-lymphocyte system. Only some of the lymphocytic, a small fraction of the lymphoblastic, and very few immunoblastic lymphomas originate from the T-lymphocyte system. True reticulosarcomas are very rare and will have to be redefined.

The Histopathology of Malignant Lymphoma

– The original Japanese paper was published in The Journal of the Japanese Society for Lymphoreticular Tissue Research (the predecessor of Journal of Clinical and Experimental Hematopathology) in 1980 (20(suppl):55-65). This English translation by Kengo Takeuchi in 2022 is a dedication to his mentor, Shigeo Mori (1943-). – # As the English title, “A group of patients with marked polyclonal hyperimmunoglobulinemia and severe plasma cell hyperplasia in the systemic lymph nodes: differences from plasma cell-type Castleman lymphoma” seemed to be closer to the meaning of the title of the original Japanese paper; the English title listed as reference 23 in the following paper was adopted in the present translation. Frizzera G, Peterson BA, Bayrd ED, Goldman A. A systemic lymphoproliferative disorder with morphologic features of Castleman’s disease: clinical findings and clinicopathologic correlations in 15 patients. J Clin Oncol. 1985;3:1202-1216. – Japanese journal names in References were translated according to the ICHUSHI database (https://www.jamas. or.jp/). – Obvious errors in the original text have been corrected by the translator as appropriate.

Idiopathic plasmacytic lymphadenopathy with polyclonal hyperimmunoglobulinemia: A syndrome related to giant lymph node hyperplasia of plasma cell type #

N. Mohri

Papers

Malignant Lymphomas Other than Hodgkin’s Disease

The Histopathology of Malignant Lymphoma

Idiopathic plasmacytic lymphadenopathy with polyclonal hyperimmunoglobulinemia: A syndrome related to giant lymph node hyperplasia of plasma cell type #