Hematology

Answer 1 Large B-cell lymphoma (large transformed cell lymphoma). Peripheral T-cell lymphoma and large B-cell lymphoma (large transformed cell lymphoma) are both intermediate grade lymphomas, according to the Working Formulation of Non-Hodgkin’s Lymphomas. For intermediate grade lymphomas, cure rates with initial chemotherapy are 40% to 45%.1 Patients with anaplastic large T-cell lymphoma have a prognosis similar to that of patients with large B-cell lymphoma, whereas patients with peripheral T-cell lymphoma have a cure rate nearer to 20%.2 Mantle cell lymphoma is a small cell lymphoma distinct from diffuse, small cleaved cell lymphoma. Although response rates to initial therapy are excellent, relapses often occur, and cures with any treatment - including stem cell transplantation - are extremely rare. Small cleaved cell lymphoma is a slowly progressive, indolent, incurable lymphoma except in very rare patients with stage I disease, who may be cured by radiation therapy. This patient has stage III disease. Small noncleaved cell lymphoma (Burkitt’s lymphoma) is a high-grade lymphoma with a 20% to 40% chance of cure with aggressive combination chemotherapy. However, survival in the absence of a complete remission is usually quite brief. REFERENCES 1. Fisher RI, Gaynor ER, Dahlberg S, et al. Comparison of a standard regimen (CHOP) with three intensive chemotherapy regimens for advanced non-Hodgkin’s lymphoma. N Engl J Med 1993;328:1002-6. 2. Siegert W, Agthe A, Griesser H, et al. Treatment of angioimmunoblastic lymphadenopathy (AILD)-type T-cell lymphoma using prednisone with or without the COPBLAM/IMVP-16 regimen. A multicenter study. Kiel Lymphoma Study Group. Ann Intern Med 1992;117:364-70. Click here to return to the questions

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