SURVIVAL OF PATIENTS WITH LOCALIZED DIFFUSE HISTIOCYTIC LYMPHOMA

  • 1 January 1981
    • journal article
    • research article
    • Vol. 58  (6) , 1218-1223
Abstract
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 wre 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). Patients with diffuse histiocytic lymphoma with stage I supradiaphragmatic lymph node disease are apparently curable using radiotherapy alone, achieving a 93% 11-yr actuarial disease-free survival. Patients with stage II or IIE disease 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.