TREATMENT OF PRIMARY CUTANEOUS B-CELL LYMPHOMAS OF FOLLICLE CENTER CELL ORIGIN - A CLINICAL FOLLOW-UP-STUDY OF 55 PATIENTS TREATED WITH RADIOTHERAPY OR POLYCHEMOTHERAPY

Purpose: Primary cutaneous follicle center cell lymphomas (PCFCCL) are a distinct group of cutaneous B-cell lymphomas with a favorable progn osis after radiotherapy (RT) or polychemotherapy (PCT). In the literat ure, conflicting data exist regarding the efficacy and the relapse rat e of both treatment modalities. In the present study, treatment result s and follow-up data of a large group of PCFCCL are evaluated. Patient s and Methods: Fifty-five patients with a PCFCCL who presented with sk in lesions on either the head (n = 12), the trunk (n = 35), or lower l egs (n = 8), and who were initially treated with RT (40 cases) or PCT (15 cases) were studied. Results: RT resulted in a complete remission in all 40 cases. Eight cases relapsed and three of these patients died as a result of their lymphoma. The estimated 5-year survival was 89%. Four of eight relapses and all three lymphoma-related deaths occurred in the group of patients presenting with tumor(s) on the lower legs. Treatment with cyclophosphamide, doxorubicin vincristine, and predniso ne (CHOP) or cyclophosphomide, vincristine, and prednisone (COP) resul ted in a complete remission in 14 of 15 cases. All four cases treated with COP relapsed, whereas only two of 11 patients treated with CHOP h ad a relapse. The estimated 5-year survival rate of the PCT group was 93%. Conclusion: Both RT and CHOP PCT are highly effective modes of tr eatment for PCFCCL. in localized PCFCCL, RT is the treatment of choice . In patients with multiple tumors involving anatomic nonrelated parts of the skin, CHOP rather than COP PCT is the preferred mode of treatm ent. PCFCCL on the lower legs, a subgroup that characteristically occu r in elderly patients, have a higher relapse rate and a less favorable prognosis than PCFCCL presenting on the head or trunk. (C) 1996 by Am erican Society of Clinical Oncology.