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Survival of patients with localized diffuse histiocytic lymphoma
DL Sweet, J Kinzie, ME Gaeke, HM Golomb, DL Ferguson and JE Ultmann
Twenty-eight patients with previously untreated diffuse histiocytic
lymphoma (DHL) were identified to be in pathologic stage (PS) I (11), IE
(3), II (8), or IIE (6) by exploratory laparotomy and splenectomy. Six
patients were treated with total nodal radiotherapy; 14 with an extended
mantle; 5 with an inverted Y or whole abdomen; and 3 with an involved
field. Twenty-six patients achieved a complete remission (93%) and 2
patients had persistent local disease. The median survival and disease-free
survival and for the complete response group are 56 and 51.5 mo,
respectively. Ten of the 11 stage I or IE patients had supradiaphragmatic
lymph node disease. Patients with stage I or IE disease (n = 14)
demonstrated a median survival of 72.5 mo and a median disease-free
survival of 69.5 mo; there was 1 disease-related death. Patients with stage
II or IIE disease (n = 14) demonstrated a median survival of 33 mo and
median disease-free survival of 29.5 mo; there were 10 relapses or deaths.
Patients in stages I, IE, II, or IIE with infradiaphragmatic disease (n =
7) had a median survival of 36 mo, while patients with supradiaphragmatic
presentation (n = 21) demonstrated median survival of 68 mo (p = 0.37). The
data indicate that patients with diffuse histiocytic lymphoma with stage I
supradiaphragmatic lymph node disease are curable using radiotherapy alone,
achieving a 93% 11-yr actuarial disease-free survival. Patients with stage
II or IIE diseases are not readily curable with radiation therapy alone,
achieving a 33% 11-yr actuarial disease-free survival; radiotherapy with
adjuvant chemotherapy or chemotherapy alone should be considered for this
group.
Volume 58,
Issue 6,
pp. 1218-1223,
12/01/1981
Copyright © 1981 by The American Society of Hematology
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