Aj. Norton et al., MANTLE CELL LYMPHOMA - NATURAL-HISTORY DEFINED IN A SERIALLY BIOPSIEDPOPULATION OVER A 20-YEAR PERIOD, Annals of oncology, 6(3), 1995, pp. 249-256
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.