78836
document
Histologic conversion in the non-Hodgkin 's lymphomas . Between July 1 , 1971 and December 31 , 1978 , 150 patients with favorable subtypes of non-Hodgkin 's lymphoma [ nodular poorly differentiated lymphocytic ( NLPD ) , nodular mixed , or diffuse well differentiated lymphocytic ] were entered into prospective randomized clinical trials at Stanford University . Treatments included involved field , total lymphoid , or whole body irradiation , single alkylating agent chemotherapy , combination chemotherapy with cyclophosphamide , vincristine and prednisone ( CVP ) or with cyclophosphamide , vincristine , procarbazine , and prednisone ( C-MOPP ) , or various combinations of chemotherapy and irradiation . The initial complete response rate ( CR ) was 79 % . Among patients who achieved a CR , 31 % later relapsed . There were 78 patients who either failed to achieve a CR or achieved a CR and later relapsed . Histologic conversion ( change from initially favorable to an unfavorable subtype of non-Hodgkin 's lymphoma ) was documented in 22/78 patients ( 28 % ) . However , the actuarial risk for conversion was actually much greater ( 60 % at 8 yr ) . The median time to documentation of conversion was 51 mo . The most common type of histologic conversion was from NLPD to diffuse histiocytic lymphoma . Documented histologic conversion was often associated with a more aggressive clinical behavior of the lymphoma , and the median survival after conversion was less than 1 yr . However , those patients who achieved a CR after conversion had a more favorable outcome ( actuarial survival 75 % at 5 yr ) . No specific risk factors predictive of histologic conversion could be identified .
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Intervention_Physical
field , total lymphoid , or whole body irradiation
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Intervention_Pharmacological
single alkylating agent chemotherapy
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Intervention_Pharmacological
combination chemotherapy with cyclophosphamide
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Intervention_Pharmacological
vincristine and prednisone ( CVP )
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Intervention_Pharmacological
cyclophosphamide
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Outcome_Physical
Histologic conversion
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Outcome_Physical
complete response rate ( CR )
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Outcome_Physical
achieved a CR
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Outcome_Physical
relapsed .
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Outcome_Physical
achieve a CR
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Outcome_Physical
achieved a CR
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Outcome_Physical
relapsed . Histologic conversion
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Outcome_Mental
actuarial risk for conversion
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Outcome_Mental
greater
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Outcome_Physical
median time to documentation of conversion
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Outcome_Physical
most common
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Outcome_Physical
histologic conversion
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Outcome_Physical
histiocytic lymphoma .
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Outcome_Physical
histologic conversion
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Outcome_Physical
aggressive clinical behavior
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Outcome_Physical
median survival
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Outcome_Physical
conversion
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Outcome_Physical
achieved a CR
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Outcome_Physical
conversion
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Outcome_Physical
favorable outcome ( actuarial survival
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Outcome_Physical
risk factors
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Outcome_Physical
histologic conversion
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Participant_Condition
non-Hodgkin 's lymphomas
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Participant_Sample-size
150
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Participant_Condition
non-Hodgkin 's lymphoma