PERIPHERAL T-CELL LYMPHOMAS - CLINICOPATHOLOGICAL STUDY OF 168 CASES DIAGNOSED ACCORDING TO THE REAL CLASSIFICATION

Background. One hundred sixty-eight peripheral T-cell lymphomas (PTCLs ) were reviewed according to the Revised European-American Lymphoma (R .E.A.L.) Classification. Patients and methods. The cases, originally d iagnosed on the basis of the Updated Kiel Classification (UKC), were a ll provided with histological preparations, immunophenotype clinical i nformation: and follow-up data. The slides were reclassified by five o bservers, who integrated the R.E.A.L criteria with cell size measureme nts. The prognostic value of clinical and pathologic findings was asse ssed by univariate and multivariate analysis. Results. The R.E.A.L. Cl assification was reproducibly applied by all of the observers. Clinica lly, anaplastic large cell lymphomas (ALCLs) differed from the remaini ng PTCLs by mean age (29.5 vs. 52.9 years), bulky disease (52.3% vs. 1 1.3%; P = 0.000), mediastinal mass (52.7% vs. 32%; P = 0.004), and dis ease-free survival(68.0% vs. 38.2%; P = 0.0001). Although each histolo gical type displayed specific clinical aspects, PTCLs other than ALCL were basically characterised by a poor clinical outcome which was not influenced by the UKC malignancy grade. At multivariate analysis, the risk of a lower complete remission rate was related to bulky disease ( P 0.001), histologic group (non-ALCL) (P = 0.01), and advanced stage ( III-IV) (P = 0.0002). Conclusions. The present study supports the clas sification of T-cell lymphomas proposed by the R.E.A.L. scheme.