HETEROGENEITY OF NEOPLASTIC AND REACTIVE CELL-PROLIFERATION IN NON-HODGKINS-LYMPHOMAS LINKED TO PATIENT SURVIVAL

This study was undertaken to determine the characteristics of the prol iferation of malignant and reactive cells in non-Hodgkin's lymphoma (N HL). Cell kinetics were studied in 76 previously untreated cases of NH L by flow cytometry after a double labeling of membrane antigen and DN A. Results were analyzed according to clinical and biologic characteri stics of the patients. In B-cell NHL, percentages of B and T cells in S-phase were strongly linked (r = .82). The level of proliferation of malignant B cells and reactive T cells was significantly higher in agg ressive lymphomas, compared with low grade, diffuse small cleaved cell NHL or reactive lymph nodes (P <.001). The percentages of malignant B cells in S-phase were lower when reactive T cells were more numerous (n = 59, r = -.264, P <.05), particularly in high-grade NHL (n = 16, r = -.78, P <.001). In the whole population of patients, survival was l onger when the percentage of cells in S-phase (n1 = 38, n2 = 33) or S + G2 + mitosis (M) (n1 = 36, n2 = 35) was less than 3.2% and 7.25%, re spectively (P <.005). When considering only B-cell NHL, survival was l onger when the percentage of B cells in S-phase was less than 4.5% (n1 = 31, n2 = 28, P <1.04). Among the slowly proliferative groups of lym phomas, this prognostic value was retained when S-phase value was less than 1% (n1 = 16, n2 = 13, P <.002). Furthermore, prognosis was bette r when the percentage of T cells in S-phase was less than 2.75% (n1 = 30, n2 = 29, P <.01) or when reactive CD4-positive T cells were more t han 14.5% (n1 = 24, n2 = 24, P <.04). This result remained true in the group of highly proliferative lymphomas. These results illustrate the complexity of the interactions between malignant and reactive cells i n NHL, with possible opposite effects on tumor cell growth.