Prognostic significance of proliferative and apoptotic fractions in low grade follicle center cell‐derived non‐Hodgkin's lymphomas

• Published in: Cancer 1996-03, Vol.77 (6), p.1180-1188
• Main Authors: Czader, Magdalena, Mazur, Joanna, Pettersson, Mikael, Liliemark, Jan, Strömberg, Mats, Christensson, Birger, Tribukait, Bernard, Auer, Gert, Öst, Åke, Porwit, Anna
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; apoptosis; Apoptosis - physiology; Biological and medical sciences; Cell Division; centroblastic‐centrocytic; DNA - analysis; DNA ploidy; Female; Flow Cytometry; Germinal Center - pathology; Hematologic and hematopoietic diseases; Humans; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Lymphoma, Non-Hodgkin - mortality; Lymphoma, Non-Hodgkin - pathology; Male; Medical sciences; Medicin och hälsovetenskap; Middle Aged; non‐Hodgkin's lymphoma; Prognosis; proliferation; S‐phase
• ISSN: 0008-543X; 1097-0142
• DOI: 10.1002/(SICI)1097-0142(19960315)77:6<1180::AID-CNCR26>3.0.CO;2-X

BACKGROUND The biologic parameters, DNA ploidy and proliferative activity, have been suggested as prognostic factors in non‐Hodgkin's lymphoma (NHL). However, reports on the prognostic importance of these factors in follicle center cell‐derived (FCC) centroblastic/centrocytic (CB/CC) NHL patients with long follow‐up are scarce. METHODS Apoptotic fractions were quantified in 60 patients with CB/CC NHL by in situ labeling of DNA strand breaks in nuclei [TdT‐mediated dUTP/dATP in situ 3′OH—end labeling (TUNEL)]. The findings were related to S‐phase and MIB‐1 counts, DNA ploidy, and clinical outcome. RESULTS In CB/CC NHL, the percentages of proliferating and apoptotic cells were lower than in reactive germinal centers (GC; P < 0.05; mean, 0.188 vs. 3.263% and 19.05 vs. 69.4% for TUNEL and MIB‐1 positive cells in CB/CC and GC, respectively). Significantly higher percentages of MIB‐1 and TUNEL positive cells were observed in patients with complete remission when compared with the partial remission/no response group (P < 0.01). The size of proliferative and apoptotic fractions did not correlate with the overall survival of the patients. However, follicular and diffuse growth pattern, elevated serum lactic dehydrogenase, advanced stage, and age indicated a lower probability of 5‐ and 10‐year survival. CONCLUSIONS The investigation of proliferative and apoptotic fractions in FCC lymphomas may help to define groups of patients who would benefit from aggressive, high dose therapy protocols and patients to whom less aggressive strategies can be applied safely. Cancer 1996;77:1180‐8.