Peripheral T-cell lymphomas. Clinico-pathologic study of 168 cases diagnosed according to the R.E.A.L. Classification |
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Authors: | S Ascani P L Zinzani F Gherlinzoni E Sabattini A Briskomatis A de Vivo M Piccioli G Fraternali Orcioni F Pieri A Goldoni P P Piccaluga D Zallocco R Burnelli L Leoncini B Falini S Tura and S A Pileri |
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Institution: | (1) Service of Pathologic Anatomy and Unit of Hematopathology – Institute of Hematology and Clinical Oncology L. & A. Seràgnoli', Bologna University, Italy;(2) Department of Pediatric Oncology, Bologna University, Italy;(3) Institute of Pathologic Anatomy and Histopathology, Siena University, Italy;(4) Institute of Hematology, Perugia University, Italy |
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Abstract: | Background: One hundred sixty-eight peripheral T-cell lymphomas (PTCLs)were reviewed according to the Revised European–American Lymphoma (R.E.A.L.)Classification.Patients and methods: The cases, originally diagnosed on the basis of theUpdated Kiel Classification (UKC), were all provided with histologicalpreparations, immunophenotype, clinical information, and follow-up data. Theslides were reclassified by five observers, who integrated the R.E.A.Lcriteria with cell size measurements. The prognostic value of clinical andpathologic findings was assessed by univariate and multivariate analysis.Results: The R.E.A.L. Classification was reproducibly applied by all of theobservers. Clinically, anaplastic large cell lymphomas (ALCLs) differed fromthe remaining PTCLs by mean age (29.5 vs. 52.9 years), bulky disease(52.3% vs. 11.3%; P = 0.000), mediastinal mass (52.7% vs.32%; P = 0.004), and disease-free survival (68.0% vs.38.2%; P = 0.0001). Although each histological type displayed specificclinical aspects, PTCLs other than ALCL were basically characterised by a poorclinical outcome which was not influenced by the UKC malignancy grade. Atmultivariate analysis, the risk of a lower complete remission rate was relatedto bulky disease (P = 0.001), histologic group (non-ALCL) (P = 0.01), andadvanced stage (III–IV) (P = 0.0002).Conclusions: The present study supports the classification of T-celllymphomas proposed by the R.E.A.L. scheme. |
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Keywords: | anaplastic large cell lymphoma classification clinics histology immunohistochemistry peripheral T-cell lymphoma |
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