S. McKenzie

Lymphoblastic lymphoma in adults.

Fifty-one patients with lymphoblastic lymphoma (LBL) treated with one of five successive intensive chemotherapy protocols for acute lymphoblastic leukemia (ALL) since 1971 were reviewed. The patients were divided into leukemic and nonleukemic groups, and their clinical and laboratory parameters compared. The projected 5-year survival rate for all patients treated with the L10/17 protocols was 45% for both leukemic and nonleukemic LBL. The response to treatment was compared with that of 111 patients with ALL and was nearly identical. Poor prognostic factors were age beyond 30, WBC greater than 50,000/microL, failure to achieve a complete response (CR), and a late CR during induction. Leukemia at presentation, T cell surface markers, and the presence of a mediastinal mass did not adversely affect survival. The use of intensive chemotherapy protocols has proven to be a significant advance in the treatment of LBL.

Grading follicular lymphomas in fine-needle aspiration biopsies: the role of ThinPrep slides and flow cytometry.

The World Health Organization (WHO) recommends a 3‐tier grading system (Grades 1–3) for follicular lymphomas (FLs) based on the absolute number of centroblasts per high‐power microscopic field (HPF) in 10 neoplastic follicles. Grades 1 and 2 FL are still managed as indolent FLs, whereas Grade 3 FL is thought to behave more aggressively. In this study, the feasibility of grading FL using ThinPrep (TP) slides and flow cytometry (FC) was evaluated.

The role of bone marrow aspiration and biopsy in detecting marrow involvement by nonhematologic malignancies

A review of the records of the Memorial Sloan‐Kettering Cancer Center identified 291 adult patients with nonhematologic malignancies who had undergone simultaneous bone marrow aspiration and biopsy from the same anatomic site. In 236 cases both samples were negative for tumor whereas in 39 both were positive. The biopsy was positive in three patients with a negative aspirate whereas in three others the aspirate was positive with a negative biopsy. The higher rate of tumor detection on aspirate in comparison with previous reports may be due to a thorough initial screening provided by technologists. Both aspiration and biopsy appear to be indicated for full evaluation of bone marrow in cancer patients.

Treatment of acute nonlymphocytic leukemia in adults: Response to 2,2-anhydro-1-B-D-Arabinofuranosyl-5-fluorocytosine and thioguanine on the L-12 protocol

Fifty‐one adult patients with acute nonlymphocytic leukemia (excluding acute promyelocytic leukemia) were treated on the L‐12 protocol. The L‐12 differed from the preceding L‐6 in that 2,2‐anhydro‐1‐B‐D‐arabinofuranosyl‐5‐fluorocytosine (AAFC), replaced arabinosylcytosine (ara‐C) together with 6‐thioguanine (TG) for remission induction. Achievement of remission was followed by an extended 14‐week multi‐drug consolidation program. With this more intense regimen, an overall complete remission rate of 49% and a median remission duration of 23.7 months were achieved; these results were not significantly better than the 57% complete remission rate and 8.6 months median remission duration obtained with the L‐6 regimen. Four year disease‐free survival was 22% on the L‐12 compared with 16% on the L‐6 protocol. No relationship between prognosis and FAB classification was found on either the L‐6 or the L‐12 protocol.