Primary Ki-1 anaplastic large-cell lymphoma in adults: clinical characteristics and therapeutic outcome.

Abstract

PURPOSE:

A study was undertaken to improve our understanding of the clinicopathologic features and therapeutic outcome for adults with primary Ki-1 anaplastic large-cell lymphoma (ALCL).

PATIENTS AND METHODS:

A retrospective review of records of 31 adult patients with primary Ki-1 ALCL was performed. The analysis included stage and distribution of disease, tumor-cell phenotype, response to initial and salvage therapy, and disease-free and overall survival.

RESULTS:

The median age of patients was 44 years (range, 16 to 86). Forty-eight percent of patients tested had lymphomas of T-cell phenotype, 30% lymphomas of B-cell phenotype, and 22% of non-T-, non-B-cell phenotype. Twenty-nine percent of patients had stages I and II disease, 65% demonstrated extranodal involvement, and 32% had skin involvement at presentation. Most patients received intensive chemotherapy and 48% achieved a sustained complete remission (CR), with an additional 17% of patients treated successfully with salvage therapy. Stage was highly predictive of achieving a sustained CR, but bulk disease and B symptoms did not predict for relapse after initial therapy or survival. Of seven patients who underwent autologous bone marrow transplantation (ABMT), three remain disease-free 9 to 42 months after transplant.

CONCLUSION:

Patients with Ki-1 ALCL have a high frequency of advanced-stage disease and extranodal involvement and are more likely to have tumors of T-cell phenotype than patients with large-cell lymphoma. However, response to standard lymphoma chemotherapy is similar to other patients with large-cell lymphoma, with a high remission rate in early-stage disease. Patients with advanced-stage disease have a poor remission duration and may require more intensive therapy, as may also be the case with large-cell lymphoma.

• Authors: L N Shulman, B Frisard, J H Antin, C Wheeler, G Pinkus, N Magauran, P Mauch, E Nobles, R Mashal, G Canellos
• Journal: Journal of clinical oncology : official journal of the American Society of Clinical Oncology (J Clin Oncol) Vol. 11 Issue 5 Pg. 937-42 (May 1993) ISSN: 0732-183X [Print] United States
• PMID: 8387578 (Publication Type: Journal Article, Research Support, U.S. Gov't, P.H.S.)

Chemical References

• Antigens, CD
• Antigens, Neoplasm
• Ki-1 Antigen

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Antigens, CD (analysis)
• Antigens, Neoplasm (analysis)
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Female
• Follow-Up Studies
• Humans
• Ki-1 Antigen
• Lymphoma, Large B-Cell, Diffuse (drug therapy, immunology, pathology)
• Male
• Middle Aged
• Neoplasm Staging
• Outcome Assessment, Health Care
• Phenotype
• Retrospective Studies
• Salvage Therapy