Peripheral T‐cell non‐Hodgkin's lymphomas of low malignancy: prospective study of 25 patients with pleomorphic small cell lymphoma, lymphoepitheloid cell (Lennert's) lymphoma and T‐zone lymphoma

Abstract

Peripheral T-cell lymphomas comprise a heterogenous group of low- and high-grade malignancies differing in their histopathological appearance and also in clinical and prognostic aspects. We prospectively studied 25 patients with low-grade peripheral T-cell lymphomas: pleomorphic, small cell lymphoma (PSC) (n = 9), lymphoepitheloid (Lennert's) lymphoma (LEL) (n = 12) and T-zone lymphoma (TZL) (n = 4). The median patient age was 55 years (range 19-75 years); the male to female ratio was 1.5. 13 patients (52%) had limited stages (I+II), 12 patients (48%) had advanced disease (stage III+IV). 21 patients received the COPBLAM/IMVP-16 regimen. Two patients received more intensive treatments; two received less intensive therapy. Complete remissions were achieved in 16/25 patients (64%). The median observation time of surviving patients was 30 months (range 5-72 months). The actuarial overall survival and event-free survival at 2 years of 21 patients receiving COPBLAM/IMVP-16 were 69% and 35%, respectively. Intensive chemotherapy led to complete remissions in about 60% of the patients and to long-term disease-free survival for one-third. The observed clinical courses illustrate the aggressive nature of PSC, LEL and TZL.

Nodal peripheral T-cell lymphomas and, in particular, their lymphoepithelioid (Lennert?s) variant are often derived from CD8+ cytotoxic T-cells

“…5). In prospective studies, survival reached a plateau at 43% after 3 years [41], and 41% of the patients, treated with an intensive regimen, were alive after 5 years [15]. The poorer outcome in our cohort was probably caused by the heterogeneous treatment, because patients receiving either CHOP [cyclophosphamide, hydroxydaunomycin, vincristine (= Oncovin), predisone (regimen)] or a highdose regimen with autologous stem cell transplant had a significantly better survival rate than those treated with a less intense regimen.…”

High-dose therapy with autologous stem cell transplantation in patients with peripheral T cell lymphomas

“…6,7 According to the REAL classification 2,9 the PTCL have a significantly poorer prognosis than diffuse large B cell lymphomas. Some investigators have therefore suggested that patients with PTCL should receive more intensive treatment such as HDT with autologous stem cell support, even in first remission.…”

“…1,2 PTCL are generally described as aggressive with disseminated disease at diagnosis and poor survival when treated with the same regimens as high-grade B cell lymphomas. [3][4][5][6][7][8] However, PTCL are a heterogeneous group of lymphomas whose aggressiveness may vary depending on subtype. Anaplastic large cell lymphomas (ALCL) constitute a subgroup of PTCL with better response to treatment and overall survival.…”

Cell behavior and signal molecule involvement in a case study of malignant histiocytosis: A negative model of morphine as an immunoregulator

“…In regard to HM, from a histological perspective, hematophagocytosis can be carried out not only by macrophages or tissue histiocytes, but also by hematopoietic and non-hematopoietic malignant tumor cells [4]. It is well established that malignant lymphomas can recruit reactive cells [4].…”

“…It is well established that malignant lymphomas can recruit reactive cells [4]. In Hodgkin's disease, for instance, reactive lymphocytes, macrophages, and leukocytes can be the predominant cells [5].…”