KARYOTYPE AND PROGNOSIS IN NON-HODGKIN-LYMPHOMA

In malignant non-Hodgkin lymphomas (NHL), cytogenetic analysis may pro vide prognostic information including prediction of histologic evoluti on and responsiveness to therapy. In this study, we correlate clinical data and chromosomal aberrations in 70 adult patients with newly diag nosed NHL followed for a median of 20 months. Clonal aberrations were detected in 68/70 patients (97%). Besides t(2;5)(p23;q35), observed ex clusively in three patients with anaplastic large cell lymphoma, Ki-1 positive, none of the characteristic aberrations observed was specific for a given histological subtype. Aberrations of chromosome 7 (n=21) occurred in all histological subtypes together with aberrations of chr omosome 3 and of the short arm of chromosome 17. They were clinically associated with a high serum lactate dehydrogenase level (LDH) and a t rend to short survival. Anomalies of the long arm of chromosome 13 (n= 10) were found in patients with high grade B-cell lymphomas and bulky disease. In t(14;18)(q32;q21) bearing lymphomas (n=27), distinct patte rns of additional aberrations were observed in low grade and high grad e lymphomas: trisomy 3 and trisomy 18 occurred concomitantly in high g rade lymphomas (n=6, p<0.001) as well as aberrations of 1q, 5q, 6q and +der (18)(q21). In conclusion, cytogenetic analysis provides informat ion about the complexity of genetic changes in NHL. These changes act not only as indicators of disease activity, but influence clinical out come as demonstrated by their stringent correlation to the Internation al Index and might reveal more general rules of tumor growth and sprea ding.