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Prognosis of non-Hodgkin's lymphomas with special emphasis on the staging classification

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Summary

The prognosis of the non-Hodgkin's lymphomas is determined by

  1. 1.

    the pattern of origin and spread which can be demonstrated in a staging classification,

  2. 2.

    the histopathological type, and

  3. 3.

    the effectiveness and scope of the treatment methods, particularly radio- and chemotherapy.

In the following paper the Ann Arbor Classification, which was originally conceived of for both disease groups (Hodgkin's and non-Hodgkin's lymphomas), is discussed particularly with respect to the applicability and prognostic evaluation for the non-Hodgkin's lymphomas.

The Ann Arbor Classification may in essence reflect the oncological characteristics of the non-Hodgkin's accurately; there are, however, a number of findings with qualitative and quantitative differences which defy integration into the Ann Arbor Classification.

The qualitative differences consist of the differing lymphatic and extralymphatic origins and their consequence for spread and prognosis. The quantitative differences refer to the varying patterns of distribution of the different stages of spreading, whereby the dissemination stages in the non-Hodgkin's lymphomas are more dependent on the histological form than is the case with the Hodgkin's lymphomas, and thus must play a greater role in the prognostic evaluation and indication for treatment. Suggestions have been made for a modification of the Ann Arbor Staging Classification for the non-Hodgkin's lymphomas.

Zusammenfassung

Die Prognose der non-Hodgkin Lymphome wird bestimmt

  1. 1.

    von dem Entstehungs- und Ausbreitungsmuster, das in einer Stadieneinteilung zum Ausdruck gebracht werden kann,

  2. 2.

    vom histopathologischen Typ und

  3. 3.

    von der Wirksamkeit und dem Anwendungsbereich der Behandlungsmethoden, insbesondere der Radio- und Chemotherapie.

Die vorliegende Arbeit befaßt sich insbesondere mit der Gültigkeit der für beide Krankheitsgruppen (Hodgkin- und non-Hodgkin Lymphome) konzipierten Ann Arbor Classification der non-Hodgkin Lymphome, insbesondere für die Möglichkeiten ihrer Anwendbarkeit und prognostischen Beurteilung.

Die Ann Arbor Classification vermag die onkologische Charakteristik der non-Hodgkin Lymphome grundsätzlich richtig wiederzugeben, es gibt aber eine Reihe von Befunden, die nicht ohne weiteres in der Ann Arbor Classification einzuordnen sind. Bei diesen sind qualitative und quantitative Unterschiede zu unterscheiden.

Die qualitativen Unterschiede sind die unterschiedliche lymphatische und extralymphatische Entstehung und ihre Folgen für die Ausbreitung und Prognose. Die quantitativen Unterschiede sind die unterschiedliche Verteilung auf die verschiedenen Ausbreitungsstadien mit stärkerer Bevorzugung der Disseminationsstadien bei den non-Hodgkin Lymphomen. Die Abhängigkeit der Prognose und Therapie ist bei den non-Hodgkin Lymphomen in stärkerem Maße von der histologisohen Form als bei den Hodgkin-Lymphomen abhängig, so daß sie stärker in die prognostische Beurteilung und Behandlungsindikation einbezogen werden muß. Es werden Vorschläge für eine Modifikation der Ann Arbor Stadieneinteilung für die non-Hodgkin Lymphome gemacht.

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References

  • Banfi,A., Bonadonna,G., Carnevali,G., Molinari,R., Monfardini,S., Salvini,E.: Lymphorereticular sarcomas with primary involvement of Waldeyers ring. Cancer26,341–351 (1970)

    Google Scholar 

  • Banfi,A., Bonadonna,G., Carnevali,G., Oldini,C., Salvini,E.: Preferential sites of involvement and spread in malignant lymphomas. Europ. J. Cancer4, 319–324 (1968)

    Google Scholar 

  • Brown,T.C., Peters,M.V., Bergsagel,O.E., Reid,I.: A retrospective analysis of the clinical results in relation to the Rappaport histological classification. Symposium on Non-Hodgkin's Lymphomata, London, 8–12 October 1973 Brit. J. Cancer30, Suppl. C. II (1974)

  • Canellos,G.P., De Vita,V.T., Young,R.C., Chabner,D.A., Schein,P.S., Johnson,R.E.: Therapy of advanced lymphocytic lymphoma: a preliminary report of a randomized trial between combination chemotherapy (CVP) and intensive radiotherapy. Symposium on Non-Hodgkin's Lymphomata, London 8–12 October, 1973 Brit. J.Cancer30, Suppl. II (1974)

  • Carbone,P.P., Kaplan,H.S., Musshoff,K., Smithers,D.W., Tubiana,M.: Report of the Committee on Hodgkin's disease staging procedures. Cancer Res.31, 1860–1861 (1971)

    Google Scholar 

  • Cox,J.D., Koehl,R.H., Turner,W.M., King,F.M.: Irridation in the local control of malignant lymphoreticulartumprs.(Non-Hodgkin'smalignantlymphoma). Radiology112, 179–185 (1974)

    Google Scholar 

  • Dancot,H.: Über die Heilungsaussichten bei Lymphosarkomen und Retikulosarkomen durch Bestrahlung (Ergebnisse einer Untersuchung bei 395 Fällen). Deutscher Röntgenkongreß 1966, Teil B, Strahlenbehandlung und Strahlenbiologie. Sonderbände zur Strahlentherapie64, 283 (1967)

    Google Scholar 

  • Dancot,H. and Feremans,W.: The curability of lympho- and reticulosarcomas. In: Musshoff,K. (Ed.): Recent Results in Cancer Research Vol. 46, “Diagnosis and Therapy of Malignant Lymphoma”, pp. 201–205. Berlin· Heidelberg· New York· Springer 1974

    Google Scholar 

  • Dorfman,R.F.: Relationship of histology to site in Hodgkin's disease Cancer Res.31, 1786–1993 (1971)

    Google Scholar 

  • Easson,E.C., Russel,M.H.: The cure of Hodgkin's disease. Brit. med. J.1963I, 1704–1707

  • Freeman,C., Berg,J.W., Cutler,S.J.: Occurence and prognosis of extranodal lymphomas. Cancer29, 252–260 (1972)

    Google Scholar 

  • Fuller,L.M., Gamble,J.F., Stullenberger,C.C., Butler,J.J., Gohan,E.A.: Prognostic factors in localized Hodgkin's disease treated with regional radation. Radiology98, 641–654 (1971)

    Google Scholar 

  • Goffinet,D.R., Castellino,R.A., Kim,H., Dorfman,R.F., Fuks,Z., Rosenberg,S.A., Nelsen,T., Kaplan,H.S.: Staging laparotomies in unselected previously untreated patients with Non-Hodgkin's lymphomas. Cancer32, 672–681 (1973)

    Google Scholar 

  • Hanks,G.E., Terry,L.N., Bryan,J.A., Newsome,J.F.: Contribution of diagnostic laparotomy to Staging non-Hodgkin's lymphomas. Cancer29, 41–43 (1972)

    Google Scholar 

  • Hohl,K.: Present results in the treatment of malignant lymphomas. Results obtained in a series of 317 cases. In: Musshoff,K. (Ed.): Recent Results in Cancer Research Vol. 46, “Diagnosis and Therapy of Malignant Lymphoma”, pp. 233–239. Berlin· Heidelberg· New York· Springer 1974

    Google Scholar 

  • Hutchison,G.B.: Criteria of cure: Statistical considerations. Nat. Cancer Inst. Monogr.36, 561–565 (1973)

    Google Scholar 

  • Johnson,R.E.: Remission Induction and Remission Duration with primary Radiotherapy in advanced Lymphosarcome. Cancer29, 1473–1476 (1972)

    Google Scholar 

  • Johnson,R.E.: Management of generalized malignant lymphomas with “systematic” radiotherapy. Symposium on Non-Hodgkin's Lymphomata London 8–12 October, 1973. Brit. J. Cancer30, Suppl. II (1974a)

  • Johnson,R.E.: Radiotherapy of Non-Hodgkin's lymphomas. XI. International Cancer Congress, Florence, 20–26 October, 1974. Symposium 15, “Lymphomas: Management and Prognosis”. Excerpta Medica, Proceedings, XI International Cancer Congress, Florence 20–26 October, 1974b, in press

  • Johnson,R.E., De Vita,V.T., Kun,L.E., Chabner,B.R., Cretien,P.B., Berard,C.W., Johnson,S.K.: Pattern of involvement with malignant lymphoma and implications for treatment decision making. Symposium on Non-Hodgkin's Lymphomata London 8–12 October, 1973. Brit. J. Cancer,30, Suppl. II (1974)

  • Jones,S.E., Fuks,Z., Bull,M., Kadin,M.E., Dorfman,R.F., Kaplan,S.K., Rosenberg,S.A., Kim,H.: Non-Hodgkin's Lymphomas. Cancer31, 806–823 (1973)

    Google Scholar 

  • Jones,S.E., Kaplan,H.S., Rosenberg,S.A.: Non-Hodgkin's Lymphomas. III. Preliminary results of radiotherapy and a proposal for new clinical trials. Radiology103, 657–662 (1972)

    Google Scholar 

  • Kaplan,H.S.: Longterm results of palliative and radical radiotherapy of Hodgkin's disease. Cancer Res.26, 1200–1252 (1966)

    Google Scholar 

  • Kaplan,H.S.: Prognostic significance of the relapse free interval after radiotherapy in Hodgkin's disease. Cancer22, 1131–1136 (1968)

    Google Scholar 

  • Kaplan,H.S.: On the natural history, treatment and prognosis of Hodgkin's disease. Harvey Lectures, Series64, 215–259, (1969/1970)

    Google Scholar 

  • Kaplan, H.S.: Prognosis of non-Hodgkin's lymphomas. XI. International Cancer Congress, Florence, 20–26 October 1974, Symposium 15 “Lymphomas: Management and Prognosis”. Excerpta Medica, Proceedings, XI. International Cancer Congress, Florence 20–26 October, 1974, in press

  • Kaplan,H.S., Bissinger,P.A.: Survival and relapse rates in Hodgkin's disease: Stanford Experience 1961–1971. Nat. Cancer Inst. Monogr.36, 487–496 (1973)

    Google Scholar 

  • Kubik,S.: The anatomy of the lymphatic system. In: Musshoff,K. (Ed.): 5–17 (1974). Recent Results in Cancer Research Vol. 46: Diagnosis and Therapy of Malignant Lymphoma, pp. 233–239. Berlin· Heidelberg· New York· Springer 1974

    Google Scholar 

  • Landberg,T., Garwicz,St., Akerman,M.: Hodgkin- and non-Hodgkin lymphom hos barn. Symposium on Non-Hodgkin's Lymphomata London 8–12 October 1973. Brit. J. Cancer,30, Suppl. II (1974)

  • Lauvers,L., Dancot,H.: Relation entre le degré d'activité de la maladie de Hodgkin au cours des cinq premières années et le devenir des malades survivant à cinq ans. Nouv. Rev. franc, émat.6, 98–101 (1966)

    Google Scholar 

  • Lowenbraun,S., Sutherland,I.C., Feldman,M.J., Serpick,A.A.: Transformation of reticulum cell sarcoma to acute leukemia. Cancer27, 579–585 (1971)

    Google Scholar 

  • Moran,E.M., Ultmann,J.E., Ferguson,D.J., Höffer,P.B., Ranninger,K., Rappaport,H.: Staging laparotomie in non-Hodgkin's lymphomas. Symposium on Non-Hodgkin's Lymphomata London 8–12 October, 1973. Brit. J. Cancer,30, Suppl. II (1974)

  • Musshoff,K.: Therapy and prognosis of two different forms of organ involvement in cases of malignant lymphoma (Hodgkin's disease, reticulum cell sarcoma, lymphosarcoma) as well as a report about stage division in these disease. Klin. Wschr.48, 673–678 (1970)

    Google Scholar 

  • Musshoff,K.: Prognostic and therapeutic implications of staging in extranodal Hodgkin's disease. Cancer Res.31, 1814–1827 (1971)

    Google Scholar 

  • Musshoff,K.: Survival and relapse data in Hodgkin's disease: Freiburg (Brsg), 1948–1961 Nat. Cancer Inst. Monogr.36, 531–539 (1973)

    Google Scholar 

  • Musshoff,K., Boutis,L.: Die Heilbarkeit der Lymphogranulomatose, beurteilt nach den Behandlungsergebnissen der Freiburger Medizinischen Klinik. Verh. dtsch. Ges. inn. Med.73, 322–329 (1967)

    Google Scholar 

  • Musshoff,K., Boutis,L.: Therapy results in Hodgkin's disease, Freiburg (Brsg), 1948–1966 Cancer21, 1100–1113 (1968)

    Google Scholar 

  • Musshoff,K., Hartmann,C., Niklaus,B., Rössner,R.: Results of therapy in Hodgkin's disease: Freiburg i.Br. 1948–1971.In: Musshoff,K. (Ed.): Recent Results in Cancer Research No. 44: Diagnosis and Therapy of Malignant Lymphoma, pp. 206–220, Berlin· Heidelberg· New York· Springer 1974

    Google Scholar 

  • Musshoff,K., Oehlert,W., Hamann,W., Nuss,A.: Radiation therapy and Cure in Hodgkin's disease. Acta radiol. Ther. Phys. Biol.9, 289–301 (1970)

    Google Scholar 

  • Musshoff,K., Renemann,H., Boutis,L., Afkhan,J.: Die extranoduläre Lymphogranulomatose: Diagnose, Therapie und Prognose bei zwei unterschiedlichen Formen des Organbefalls. Ein Beitrag zur Stadieneinteilung des Morbus Hodgkin. Fortschr. Röntgenstr.104, 776–786 (1968)

    Google Scholar 

  • Musshoff,K., Schmidt-Vollmer,H., Merten,D.: Reticulum cell sarcome, on oncologic model for a system of classifyin the malignant lymphomas. Europ. J. Cancer,7, 451–457 (1971)

    Google Scholar 

  • Nissen,N.I.: Chemotherapy of Non-Hodgkin's Lymphomas. XI. International Cancer Congress, Florence, 20–26 October 1974. Symposium 15 “Lymphomas: Management and Prognosis”. Excerpta Medica, Proceedings, XI. International Cancer Congress, Florence, 20–26 October 1974, in press

  • Papillon,J.: The curability of Hodgkin's disease. In: Musshoff,K. (Ed.): Recent Results in Cancer Research No 44; Diagnosis and Therapy of Malignant Lymphoma. pp. 195–200. Berlin, Heidelberg, New York, Springer 1974

    Google Scholar 

  • Papillon,J., Croizat,P., Revol,L., Chassard,J.L., Chassard,E., Contamin,A.: Le prognostic de la maladie de Hodgkin. J. Radiol. Electrol.47, 387–390 (1966)

    Google Scholar 

  • Peters,W.V., Bush,R.S., Brown,T.C., Reid,J.: The place of radiotherapy in the control of non-Hodgkin's lymphomas. Symposium on Non-Hodgkin's Lymphomata. London 8–12 October 1973. Brit. J. Cancer,30, Suppl. II (1974)

  • Peters,M.V., Hasselback,R., Brown,Th. C.: The natural history of the lymphomas related to the clinical classification. In: Zarafonetis,C.J.D. (Ed.): Proceedings of the International Conference on Leukemia-Lymphoma, pp. 357–370. Philadelphia: Lea G. Febinger 1968

    Google Scholar 

  • Pinkel,O., Johnson,W., Aur,R.J.A.: Non-Hodgkin's Lymphoma in children. XV. Congress of the International Society of Hematology, Jerusalem, September 1–6, 1974

  • Rappaport,H.: Tumors of the hematopoitic system. Sect. 3, fasc. 8. Washington, D.S. Armed Forces Institute of Pathology, 1966; pp. 91–156

    Google Scholar 

  • Rappaport,H., Strum,St.B.: Criteria of cure: clinical-pathologic correlations. Nat. Cancer Inst. Monogr.36, 567–569 (1973)

    Google Scholar 

  • Rappaport,H., Winter,W.J., Hicks,E.B.: Follicular lymphoma: A reevaluation of its position in the scheme of malignant lymphomas, based on a survey of 253 cases. Cancer9, 729–821 (1956)

    Google Scholar 

  • Rosenberg,S.A.: Report of the Committee on the staging of Hodgkin's disease. Cancer Res.26, 1310 (1966)

    Google Scholar 

  • Rosenberg,S.G.: Bone marrow involvement in the non-Hodgkin's lymphoma. Symposium on Non-Hodgkin's Lymphomata London 8–12 October 1973. Brit. J. Cancer,30, Suppl. II (1974a)

  • Rosenberg,S.A.: Clinical evaluation and natural history of non-Hodgkin's lymphomas. XI. International Cancer Congress, Florence, 20–26 October 1974. Symposium 1 “Lymphomas: Epidemiology, diagnosis and staging”. Excerpta Medica, Proceedings, XI. International Cancer Congress, Florence, 20–26 October, 1974b, in press

  • Rosenberg,S.A., Dorfman,R.F., Kaplan,H.S.: The value of sequestrial bone marrow biopsy and laparotomy in a series of 127 consecutive untreated patients with non-Hodgkin's lymphomas. Symposium on Non-Hodgkin's Lymphomata London 8–12 October 1973. Brit. J. Cancer,30, Suppl. II (1974)

  • Rosenberg,S.A.et al.; Lymphosarcoma: A review of 1269 cases. Medizine40, 31–84 (1961)

    Google Scholar 

  • Stenfert Kroese,W.F., Cleton,F.J., Somers,R.: Leucaemic progression in lymphomas. Symposium on Non-Hodgkin's Lymphomata. London 8–12 October 1973. Brit. J.Cancer,30, Suppl. II (1974)

  • Symposium Obstacles to the Control of Hodgkin's Disease: Rye, New York, September 13–15, 1966 Cancer Res.26, 1042–1311 (1966)

    Google Scholar 

  • Symposium “Staging in Hodgkin's Disease”: Ann Arbor, Michigan, April 26–28 1971 Cancer Res.81,1707–1870 (1971)

  • Symposium on Non-Hodgkin's Lymphomata: London 8–12 October 1973. Brit. J. Cancer,30, Suppl. II (1974)

  • Veronesi,U., Musumeci,R., Pizetti,F., Gennari,L., Bonadonna,G.: The Value of staging laparotomy in non-Hodgkin's lymphomas. Cancer33, 446–459 (1974)

    Google Scholar 

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Musshoff, K., Schmidt-Vollmer, H. Prognosis of non-Hodgkin's lymphomas with special emphasis on the staging classification. Z. Krebsforsch. 83, 323–341 (1975). https://doi.org/10.1007/BF00573019

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