PROGNOSTIC-SIGNIFICANCE OF PROLIFERATIVE AND APOPTOTIC FRACTIONS IN LOW-GRADE FOLLICLE CENTER CELL-DERIVED NON-HODGKINS-LYMPHOMAS

BACKGROUND. The biologic parameters, DNA ploidy and proliferative acti vity, have been suggested as prognostic factors in non-Hodgkin's lymph oma (NHL). However, reports on the prognostic importance of these fact ors in follicle center cell-derived (FCC) centroblastic/centrocytic (C B/CC) NHL patients with long followup are scarce. METHODS. Apoptotic f ractions were quantified in 60 patients with CB/CC NHL by in situ labe ling of DNA strand breaks in nuclei [TdT-mediated dUTP/dATP in situ 3' OH-end labeling (TUNEL)]. The findings were related to S-phase and MIB -1 counts, DNA ploidy, and clinical outcome. RESULTS. In CB/CC NHL, th e percentages of proliferating and apoptotic cells were lower than in reactive germinal centers (GC; P < 0.05; mean, 0.188 vs. 3.263% and 19 .05 vs. 69.4% for TUNEL and MIB-1 positive cells in CB/CC and GC, resp ectively). Significantly higher percentages of MIB-1 and TUNEL positiv e cells were observed in patients with complete remission when compare d with the partial remission/no response group (P < 0.01). The size of proliferative and apoptotic fractions did not correlate with the over all survival of the patients. However, follicular and diffuse growth p attern, elevated serum lactic dehydrogenase, advanced stage, and age i ndicated a lower probability of 5- and 10-year survival. CONCLUSIONS. The investigation of proliferative and apoptotic fractions in FCC lymp homas may help to define groups of patients who would benefit from agg ressive, high dose therapy protocols and patients to whom less aggress ive strategies can be applied safely. (C) 1996 American Cancer Society .