LOW-GRADE LYMPHOMA - CLINICAL AND PROGNOSTIC STUDIES IN A SERIES OF 143 PATIENTS FROM A SINGLE INSTITUTION

Clinical and prognostic studies were carried out in a series of 143 pa tients with low-grade (small-lymphocytic, follicular small cleaved cel l, follicular mixed small- and large-cell) lymphoma. After treatment w ith alkylating agents (21.5% cases), combination chemotherapy (73.3%) or other therapies (5.2%), complete response (CR) was obtained in 40.7 % of cases and partial response (PR) in 43.7%. The stage of the diseas e was the most important factor for response. With a median follow-up of 6.5 years, 48.0% (95% Cl: 37.5-58.5) of patients were alive 10 year s after diagnosis. Among the initial parameters, advanced stage, B-sym ptoms, poor performance status, nodal involvement >3 sites, extranodal involvement greater than or equal to 2 sites, WBC count greater than or equal to 10 x 10(9)/L, leukemic expression, high serum LDH levels, and bone marrow infiltration were all related to survival; treatment m odality, however, had no influence on survival. In the multivariate an alysis, stage (p = 0.008) and age (p = 0.053) were the most important prognostic factors. When considering response to therapy, both CR (p < 0.001) and PR (p = 0.003) emerged as the most important predictive va riables, with only the absence of B-symptoms retaining its prognostic significance (p = 0.014) among the other parameters. In addition, in C R patients the duration of the response (less than or equal to 1 year vs. >1 year) was the most significant parameter for survival (p < 0.00 1). Finally, the initial stage (p = 0.011) and the hsitologic subtype (those patients with follicular mixed lymphoma relapsing less frequent ly than the others) (p = 0.052) were the only significant factors for relapse.