MANTLE CELL LYMPHOMA - NATURAL-HISTORY DEFINED IN A SERIALLY BIOPSIEDPOPULATION OVER A 20-YEAR PERIOD

Background: The histological, immunological and molecular characterist ics of mantle cell lymphoma have only recently been delineated. Amongs t these characteristics possible factors of prognostic significance in clude histological growth pattern and blastoid change. Patients and me thods: 66 previously untreated cases of mantle cell lymphoma were iden tified in a retrospective analysis. In 50 cases serial biopsies had be en taken during the disease and in 20 cases autopsies had been perform ed. Besides established factors of prognostic significance, histologic al growth pattern and blastoid change were examined. Results: 32 patie nts achieved an initial complete remission or good partial remission w ith most cases relapsing or progressing within 2 years. The median sur vival was 36 months. Factors predicting a poor outcome were high prese nting stage, age >70, low sodium, low albumin and splenomegaly. Blasto id transformation was also a poor prognostic feature, occurring in 32% of cases during life and in 70% of autopsies. Histological growth pat tern had no influence on outcome. Conclusion: This study emphasises th e difficulties in treating mantle cell lymphoma and the high frequency and prognostic importance of histological transformation.