TY - JOUR
T1 - Clinical significance of follicular lymphoma with monocytoid B cells
AU - Nathwani, Bharat N.
AU - Anderson, James R.
AU - Armitage, James O.
AU - Cavalli, Franco
AU - Diebold, Jacques
AU - Drachenberg, Milton R.
AU - Harris, Nancy L.
AU - Maclennan, Kenneth A.
AU - Müller-Hermelink, H. Konrad
AU - Ullrich, Fred A.
AU - Weisenburger, Dennis D.
N1 - Funding Information:
From the Department of Hematopathology, University of Southern California, Los Angeles, CA; the Statistical Department, and the Departments of Medicine and Pathology, the University of Nebraska Medical Center, Omaha, NE; the Department of Oncology, Ospedale San Giovanni, Bellinzona, Switzerland; the Department of Pathology, Hotel Dieu de Paris, France; the Department of Pathology, Harvard Medical School, Boston, MA; the Department of Pathology, St James University, Leeds, UK; and the Department of Pathology, University of W~'zburg, Wfirzburg, Germany. Accepted for publication September 9, 1998. *Study participants: The pathologists and clinicians at each institution were, respectively-: Wing C. Chan and James O. Armitage (Omaha, NE), Randy Gascoyne and Joseph Connors (Vancouver, Canada), Pauline Close and Peter Jacobs (Capetown, South Africa), Andrew Norton and T. Andrew Lister (London, UK), Ennio Pedrinis and Franco Cavalli (Locarno, S,Mtzerland), Francoise Berger and Bertrand Coiffier (Lyon, France), Faith Ho and Raymond Liang (Hong Kong), German Ott/Alfred Schauer and Wolfgang Hidde-mann (Wfirzburg/G6ttingen, Germany). The five visiting expert hematopathologists were Jacques Diebold (Paris, France), Kenneth A. MacLennan (Leeds, UK), H. Konrad Mfiller-Hermelink (Wfirzburg, Germany), Bharat N. Nathwani (Los Angeles, CA), and Dennis D. Weisenburger (Omaha, NE). Nancy L. Harris (Boston, MA) reviewed slides on 400 cases at two centers. James R. Anderson (Omaha, NE) and Pascal Roy (Lyon, France) provided statistical expertise regarding the study design and data analysis. Supported in part by US Public Health Service CA 36727 awarded by the National Cancer Institute, Department of Health and Human Services, the Foundazione San Salvatore, the Stacey Greene family, and the Imperial Cancer Research Fund, UI~ Address correspondence and reprint requests to Bharat N. Nathwani, MD, 2011 Zonal Ave, HMR-209, Los Angeles, CA 90033. Copyright © 1999 by W.B. Saunders Company 0046-8177/99/3003-0004510.00/0
PY - 1999/3
Y1 - 1999/3
N2 - Although follicular lymphoma (FL) is very common in the Western world, very little information is available regarding the frequency and significance of monocytoid B cells (MBC) in FL. We recently completed a clinicopathologic study of 1,378 cases of non-Hodgkin's lymphoma. In this study, a research data sheet was designed to conduct research on several types of lymphomas, one part of which was evaluating the presence of intrafollicular clear cells and extrafollicular MBC in 326 cases diagnosed as FL by one of the pathologists (B.N.N.). For each case diagnosed as FL, the presence of intrafollicular clear cells or extrafollicular MBC was scored as pure FL (no intrafollicular clear cells or extrafollicular MBC), FL with intrafollicular clear cells, FL with less than 5% MBC, and FL with greater than 5% MBC. Of 326 cases classified as FL, 252 (77%) had no intrafollicular clear cells or extrafollicular MBC and therefore were called pure FL. In 36 cases (11%), intrafollicular clear cells were seen, but no extrafollicular MBC. There were no clinical differences between such cases and the 252 cases of pure FL. In eight cases of FL (2%), MBC clusters were rare (<5%). In contrast, 30 cases of FL (9%) had a prominent (>5%) proliferation of extrafollicular MBC; these 30 cases had a significantly shorter failure-free survival (P = .001) and overall survival (P = .04) than the 252 cases of pure FL. The shorter survival of these 30 cases appeared to be independent of the international prognostic index (IPI), stage, and treatment. The FFS of this group remained shorter than that of cases with pure FL when the analysis was restricted to patients treated with Adriamycin-containing regimens and either a favorable (0 to 3) IPI score (P = .001) or advanced stage (III/IV) disease (P = .015). In conclusion, FL with a prominent (>5%) MBC component constitutes a substantial proportion (9%) of FL and has distinctive morphology, and these patients have a significantly shorter survival than those with pure FL.
AB - Although follicular lymphoma (FL) is very common in the Western world, very little information is available regarding the frequency and significance of monocytoid B cells (MBC) in FL. We recently completed a clinicopathologic study of 1,378 cases of non-Hodgkin's lymphoma. In this study, a research data sheet was designed to conduct research on several types of lymphomas, one part of which was evaluating the presence of intrafollicular clear cells and extrafollicular MBC in 326 cases diagnosed as FL by one of the pathologists (B.N.N.). For each case diagnosed as FL, the presence of intrafollicular clear cells or extrafollicular MBC was scored as pure FL (no intrafollicular clear cells or extrafollicular MBC), FL with intrafollicular clear cells, FL with less than 5% MBC, and FL with greater than 5% MBC. Of 326 cases classified as FL, 252 (77%) had no intrafollicular clear cells or extrafollicular MBC and therefore were called pure FL. In 36 cases (11%), intrafollicular clear cells were seen, but no extrafollicular MBC. There were no clinical differences between such cases and the 252 cases of pure FL. In eight cases of FL (2%), MBC clusters were rare (<5%). In contrast, 30 cases of FL (9%) had a prominent (>5%) proliferation of extrafollicular MBC; these 30 cases had a significantly shorter failure-free survival (P = .001) and overall survival (P = .04) than the 252 cases of pure FL. The shorter survival of these 30 cases appeared to be independent of the international prognostic index (IPI), stage, and treatment. The FFS of this group remained shorter than that of cases with pure FL when the analysis was restricted to patients treated with Adriamycin-containing regimens and either a favorable (0 to 3) IPI score (P = .001) or advanced stage (III/IV) disease (P = .015). In conclusion, FL with a prominent (>5%) MBC component constitutes a substantial proportion (9%) of FL and has distinctive morphology, and these patients have a significantly shorter survival than those with pure FL.
KW - Follucular lymphoma
KW - Monocytoid B cell lymphoma
KW - Monocytoid B cells
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U2 - 10.1016/S0046-8177(99)90003-5
DO - 10.1016/S0046-8177(99)90003-5
M3 - Article
C2 - 10088543
AN - SCOPUS:13044317488
SN - 0046-8177
VL - 30
SP - 263
EP - 268
JO - Human Pathology
JF - Human Pathology
IS - 3
ER -