T-cell-rich B-cell lymphomas: Diagnosis and response to therapy of 44 patients

J. P. Greer, W. R. Macon, R. E. Lamar, S. N. Wolff, R. S. Stein, J. M. Flexner, R. D. Collins, J. B. Cousar

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Abstract

Purpose: Clinicopathologic features of 44 patients with well-documented T- cell-rich B-cell lymphomas (TCRBCLs) were reviewed to determine if there were distinguishing clinical characteristics and to evaluate the responsiveness to therapy. Patients and Methods: Forty-one patients had de nova TCRBCL, while three patients had a prior diagnosis of diffuse large B-cell lymphoma. Seventeen TCRBCLs were identified from a retrospective analysis of 176 lymphomas diagnosed before 1988 as peripheral T-cell lymphomas (PTCLs). The initial pathologic diagnosis was incorrect in 36 of 44 cases (82%), usually due to the absence of adequate immunophenotypic and/or genotypic studies at the initial study. Results: The median age of patients was 53 years (range, 17 to 92), and the male-to-female ratio was 1.4:1. B symptoms were present in 22 of 41 patients (54%); splenomegaly was detected in 11 patients (25%). Clinical stage at diagnosis was as follows: I (n = 8), II (n = 6), III (n = 15), IV (n = 14), and unstaged (n = 1). Although therapy was heterogeneous, the disease-free survival (DFS) and overall survival (OS) rates at 3 years for patients with de nova TCRBCL were 29% and 46%, respectively. A complete response (CR) to combination chemotherapy for intermediate-grade lymphomas was observed in 16 of 26 patients (62%); 11 of these patients (42%) had a continuous CR, compared with one of 14 patients (7%) who received radiation therapy or therapy for low-grade lymphoma or Hodgkin's disease (HD) (P < .05). However, there was no difference in OS between patients who received chemotherapy for intermediate-grade lymphoma versus other therapies (49% v 48%) due to a high response rate to salvage therapies, including seven patients without disease after marrow transplantation. Conclusion: TCRBCLs are difficult to recognize without immunoperoxidase studies. Patients with TCRBCL have clinical features similar to patients with other large B-cell lymphomas, except they may have more splenomegaly and advanced-stage disease; they should receive combination chemotherapy directed at large-cell lymphomas.

Original languageEnglish (US)
Pages (from-to)1742-1750
Number of pages9
JournalJournal of Clinical Oncology
Volume13
Issue number7
StatePublished - 1995
Externally publishedYes

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B-Cell Lymphoma
T-Lymphocytes
Therapeutics
Non-Hodgkin's Lymphoma
Splenomegaly
Combination Drug Therapy
Lymphoma
Peripheral T-Cell Lymphoma
Salvage Therapy
Lymphoma, Large B-Cell, Diffuse
Hodgkin Disease
Disease-Free Survival

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Greer, J. P., Macon, W. R., Lamar, R. E., Wolff, S. N., Stein, R. S., Flexner, J. M., ... Cousar, J. B. (1995). T-cell-rich B-cell lymphomas: Diagnosis and response to therapy of 44 patients. Journal of Clinical Oncology, 13(7), 1742-1750.

T-cell-rich B-cell lymphomas : Diagnosis and response to therapy of 44 patients. / Greer, J. P.; Macon, W. R.; Lamar, R. E.; Wolff, S. N.; Stein, R. S.; Flexner, J. M.; Collins, R. D.; Cousar, J. B.

In: Journal of Clinical Oncology, Vol. 13, No. 7, 1995, p. 1742-1750.

Research output: Contribution to journalArticle

Greer, JP, Macon, WR, Lamar, RE, Wolff, SN, Stein, RS, Flexner, JM, Collins, RD & Cousar, JB 1995, 'T-cell-rich B-cell lymphomas: Diagnosis and response to therapy of 44 patients', Journal of Clinical Oncology, vol. 13, no. 7, pp. 1742-1750.
Greer JP, Macon WR, Lamar RE, Wolff SN, Stein RS, Flexner JM et al. T-cell-rich B-cell lymphomas: Diagnosis and response to therapy of 44 patients. Journal of Clinical Oncology. 1995;13(7):1742-1750.
Greer, J. P. ; Macon, W. R. ; Lamar, R. E. ; Wolff, S. N. ; Stein, R. S. ; Flexner, J. M. ; Collins, R. D. ; Cousar, J. B. / T-cell-rich B-cell lymphomas : Diagnosis and response to therapy of 44 patients. In: Journal of Clinical Oncology. 1995 ; Vol. 13, No. 7. pp. 1742-1750.
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title = "T-cell-rich B-cell lymphomas: Diagnosis and response to therapy of 44 patients",
abstract = "Purpose: Clinicopathologic features of 44 patients with well-documented T- cell-rich B-cell lymphomas (TCRBCLs) were reviewed to determine if there were distinguishing clinical characteristics and to evaluate the responsiveness to therapy. Patients and Methods: Forty-one patients had de nova TCRBCL, while three patients had a prior diagnosis of diffuse large B-cell lymphoma. Seventeen TCRBCLs were identified from a retrospective analysis of 176 lymphomas diagnosed before 1988 as peripheral T-cell lymphomas (PTCLs). The initial pathologic diagnosis was incorrect in 36 of 44 cases (82{\%}), usually due to the absence of adequate immunophenotypic and/or genotypic studies at the initial study. Results: The median age of patients was 53 years (range, 17 to 92), and the male-to-female ratio was 1.4:1. B symptoms were present in 22 of 41 patients (54{\%}); splenomegaly was detected in 11 patients (25{\%}). Clinical stage at diagnosis was as follows: I (n = 8), II (n = 6), III (n = 15), IV (n = 14), and unstaged (n = 1). Although therapy was heterogeneous, the disease-free survival (DFS) and overall survival (OS) rates at 3 years for patients with de nova TCRBCL were 29{\%} and 46{\%}, respectively. A complete response (CR) to combination chemotherapy for intermediate-grade lymphomas was observed in 16 of 26 patients (62{\%}); 11 of these patients (42{\%}) had a continuous CR, compared with one of 14 patients (7{\%}) who received radiation therapy or therapy for low-grade lymphoma or Hodgkin's disease (HD) (P < .05). However, there was no difference in OS between patients who received chemotherapy for intermediate-grade lymphoma versus other therapies (49{\%} v 48{\%}) due to a high response rate to salvage therapies, including seven patients without disease after marrow transplantation. Conclusion: TCRBCLs are difficult to recognize without immunoperoxidase studies. Patients with TCRBCL have clinical features similar to patients with other large B-cell lymphomas, except they may have more splenomegaly and advanced-stage disease; they should receive combination chemotherapy directed at large-cell lymphomas.",
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T1 - T-cell-rich B-cell lymphomas

T2 - Diagnosis and response to therapy of 44 patients

AU - Greer, J. P.

AU - Macon, W. R.

AU - Lamar, R. E.

AU - Wolff, S. N.

AU - Stein, R. S.

AU - Flexner, J. M.

AU - Collins, R. D.

AU - Cousar, J. B.

PY - 1995

Y1 - 1995

N2 - Purpose: Clinicopathologic features of 44 patients with well-documented T- cell-rich B-cell lymphomas (TCRBCLs) were reviewed to determine if there were distinguishing clinical characteristics and to evaluate the responsiveness to therapy. Patients and Methods: Forty-one patients had de nova TCRBCL, while three patients had a prior diagnosis of diffuse large B-cell lymphoma. Seventeen TCRBCLs were identified from a retrospective analysis of 176 lymphomas diagnosed before 1988 as peripheral T-cell lymphomas (PTCLs). The initial pathologic diagnosis was incorrect in 36 of 44 cases (82%), usually due to the absence of adequate immunophenotypic and/or genotypic studies at the initial study. Results: The median age of patients was 53 years (range, 17 to 92), and the male-to-female ratio was 1.4:1. B symptoms were present in 22 of 41 patients (54%); splenomegaly was detected in 11 patients (25%). Clinical stage at diagnosis was as follows: I (n = 8), II (n = 6), III (n = 15), IV (n = 14), and unstaged (n = 1). Although therapy was heterogeneous, the disease-free survival (DFS) and overall survival (OS) rates at 3 years for patients with de nova TCRBCL were 29% and 46%, respectively. A complete response (CR) to combination chemotherapy for intermediate-grade lymphomas was observed in 16 of 26 patients (62%); 11 of these patients (42%) had a continuous CR, compared with one of 14 patients (7%) who received radiation therapy or therapy for low-grade lymphoma or Hodgkin's disease (HD) (P < .05). However, there was no difference in OS between patients who received chemotherapy for intermediate-grade lymphoma versus other therapies (49% v 48%) due to a high response rate to salvage therapies, including seven patients without disease after marrow transplantation. Conclusion: TCRBCLs are difficult to recognize without immunoperoxidase studies. Patients with TCRBCL have clinical features similar to patients with other large B-cell lymphomas, except they may have more splenomegaly and advanced-stage disease; they should receive combination chemotherapy directed at large-cell lymphomas.

AB - Purpose: Clinicopathologic features of 44 patients with well-documented T- cell-rich B-cell lymphomas (TCRBCLs) were reviewed to determine if there were distinguishing clinical characteristics and to evaluate the responsiveness to therapy. Patients and Methods: Forty-one patients had de nova TCRBCL, while three patients had a prior diagnosis of diffuse large B-cell lymphoma. Seventeen TCRBCLs were identified from a retrospective analysis of 176 lymphomas diagnosed before 1988 as peripheral T-cell lymphomas (PTCLs). The initial pathologic diagnosis was incorrect in 36 of 44 cases (82%), usually due to the absence of adequate immunophenotypic and/or genotypic studies at the initial study. Results: The median age of patients was 53 years (range, 17 to 92), and the male-to-female ratio was 1.4:1. B symptoms were present in 22 of 41 patients (54%); splenomegaly was detected in 11 patients (25%). Clinical stage at diagnosis was as follows: I (n = 8), II (n = 6), III (n = 15), IV (n = 14), and unstaged (n = 1). Although therapy was heterogeneous, the disease-free survival (DFS) and overall survival (OS) rates at 3 years for patients with de nova TCRBCL were 29% and 46%, respectively. A complete response (CR) to combination chemotherapy for intermediate-grade lymphomas was observed in 16 of 26 patients (62%); 11 of these patients (42%) had a continuous CR, compared with one of 14 patients (7%) who received radiation therapy or therapy for low-grade lymphoma or Hodgkin's disease (HD) (P < .05). However, there was no difference in OS between patients who received chemotherapy for intermediate-grade lymphoma versus other therapies (49% v 48%) due to a high response rate to salvage therapies, including seven patients without disease after marrow transplantation. Conclusion: TCRBCLs are difficult to recognize without immunoperoxidase studies. Patients with TCRBCL have clinical features similar to patients with other large B-cell lymphomas, except they may have more splenomegaly and advanced-stage disease; they should receive combination chemotherapy directed at large-cell lymphomas.

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