DIFFUSE LARGE CELL LYMPHOMAS: STAGES III AND IV IN ADULTS

Important note: Information in this article was accurate in 1989. The state of the art may have changed since the publication date.

DIFFUSE LARGE CELL LYMPHOMAS: STAGES III AND IV IN ADULTS

Hodgkin's Disease and Non-Hodgkin's Lymphomas in Adults and Children. Fuller LM et al, eds. New York, Raven, p. 346-64, 1988.. Unique Identifier : AIDSLINE ICDB/89649519
Velasquez WS; Fuller LM; Jagannath S; Dept. of Hematology, Univ. of Texas M.D. Anderson Hosp. and Tumor; Inst., Houston, TX 77030

Abstract: Approx 60% of patients (pts) with diffuse large cell lymphoma (DLCL) present with Stage III or Stage IV disease. This group constitutes the largest and most important cohort of pts with intermediate- or high-grade aggressive lymphomas. Stage III or IV DLCL has become a rather frequent diagnosis in pts with acquired immune deficiency disease (after organ transplantation or due to HIV infection). Investigative procedures for determining extent of disease (computed tomography and lymphangiography), single-agent and combination chemotherapy results from several trials, and the University of Texas MD Anderson Hospital experience with Stage III and IV DLCL are reviewed. Prognostic factors and various prognostic models are discussed based on results with series of pts treated with CHOP-Bleo (cyclophosphamide, hydroxydaunomycin, Oncovin [vincristine], prednisone, and bleomycin) or M-BACOD (methotrexate with leucovorin rescue, bleomycin, Adriamycin, cyclophosphamide, vincristine, and dexamethasone). Among the prognostic factors associated with significant increased risk are presence of constitutional B symptoms, elevated lactate dehydrogenase, and high tumor burden. New treatment approaches are needed for pts in high-risk categories. Results with various biological response modifiers have been disappointing. (64 Refs)

Keywords: Acquired Immunodeficiency Syndrome/PATHOLOGY Adult Antineoplastic Agents, Combined/THERAPEUTIC USE Biopsy, Needle Bone Marrow/PATHOLOGY Clinical Trials Human Lactate Dehydrogenase/BLOOD Lymphoma, Non-Hodgkin's/DRUG THERAPY/ENZYMOLOGY/*PATHOLOGY Neoplasm Staging Prognosis Risk Factors Tumor Markers, Biological/BLOOD CLINICAL TRIAL MONOGRAPH REVIEW REVIEW, TUTORIAL

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