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Annals of Oncology 5:317-322, 1994
© 1994 European Society for Medical Oncology

research-article

Long term prognostic importance of primary Ki-1 (CD30) antigen expression and anaplastic morphology in adult patients with diffuse large-cell lymphoma

J. E. Romaguera1,, J. T. Manning, Jr.2, C. S. Tornos, J. Rodriguez1, T. E. Brooks2, W. C. Pugh2, N. G. Ordonez2, A. M. Goodacre1 and E. Cabanillas1

1Department of Hematology, The University of Texas, M.D. Anderson Cancer Center Houston, TX, USA
2Department of Pathology, The University of Texas, M.D. Anderson Cancer Center Houston, TX, USA

Correspondence to: Jorge E. Romaguera, M.D., The University of Texas, M.D. Anderson Cancer Center, 1515 Holcombe, Box 68, Houston, Texas 77030, U.S.A.

BACKGROUND:: We retrospectively assessed the long-term prognostic importance of primary CD30 antigen expression and of anaplastic large-cell morphology (ALCL) in adult patients with previously untreated diffuse large-cell lymphoma (DLCL), including cases of immunoblastic lymphoma, and identified their clinical features.

MATERIALS AND METHODS:: We examined available archival paraffin-embedded or frozen pathologic material and medical records of adult patients with previously untreated DLCL seen at M.D. Anderson Cancer Center (MDACC) between January 1978 and May 1989.

RESULTS:: Sixty-seven cases of DLCL and seven cases of IBL (a total of seventy-four heretofore referred to as DLCL) were identified. Twenty-two of the 74 patients were positive for the CD 30 antigen. For these 22 patients the rates of complete remission, survival, and time to treatment failure (TTF) were 86%, 82%, and 77%, respectively, at 81 months. When compared with the group of 54 patients which stained negative for CD 30, the long term survival of CD 30-positive DLCL was favorable (82% vs. 49%, p = 0.08). ALCL morphology was present in two-thirds of the patients with CD 30-positive DLCL but did not affect survival and TTF rates. Among patients with CD 30-positive DLCL, 16 patients without skin involvement were younger and had a low failure rate (13%) compared with six patients with skin involvement who were older and had a high failure rate (50%); however, the latter group had a more indolent course after failure and thus both groups had similar survival rates.

CONCLUSIONS:: Primary CD 30 positivity is associated with a favorable long-term prognosis in adult patients with DLCL treated with doxorubicin-containing chemotherapy. ALCL morphology among these patients does not affect the outcome. Patients with CD30-positive DLCL and skin involvement have a higher failure rate than those without skin involvement, but similar overall survival.

anaplastic large cell lymphoma, Ki-1 lymphoma, prognosis


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