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We have studied 24 cases of secondarily leukemic (stage V) lymphosarcoma (LS), 31 cases of "d'emblee" leukemic LS, and ten cases of lymphoid leukemic neoplasias transitional between "d'emblee" leukemic LS and chronic lymphocytic leukemia (eLL). These cases only concern the common types ofthe WHO classification ofLS, i.e., the prolymphocytic, the lymphoblastic, and the immunoblastic. Some cases have also been classified by cell surface markers. The secondarily leukemic conversion occurred in 40% of the lymphoblastic types, in 14% of the prolymphocytic types, and in 17% of the immunoblastic types. It never occurred at stage I but could occur after any other stage. The mediastinal involvement was observed in three types, but most often in the lymphoblastic type. The prognosis after an acute lymphoid leukemia (ALL) treatment comprising active immunotherapy following chemo(radio)therapy is better for the leukemic prolymphocytic and lymphoblastic LS than for the immunoblastic type. Two patients (one of the lymphoblastic type) are in complete remission after 8 and 5 years, respectively. We have described ten cases of "d'emblee" leukemic LS with either large lymphoid or extra lymphoid masses, bone marrow leukemic cell involvement, and LS aspects of neoplastic cells. Mediastinal, abdominal, or other tumor masses are frequent.
Sommario
I: Clinical Aspects: Staging and Therapeutic Implications.- Introductory Remarks.- Cellular Renewal Kinetics of Malignant Non-Hodgkin's Lymphomas.- Clinical Staging and New Therapeutic Approaches in Multiple Myeloma.- Staging of Myeloma. A Preliminary Study of Staging Factors and Treatment in Different Stages.- Prognostic Factors and Treatment of Multiple Myeloma: Interest of a Cyclic Sequential Chemohormonotherapy Combining Cyclophosphamide, Melphalan, and Prednisone.- Pathological Staging in Adult Previously Untreated Non-Hodgkin's Lymphomas.- Staging in Adult Non-Hodgkin's Lymphomas.- Invasion of the Upper Respiratory and Digestive Tract in Adult Lymphoid Neoplasias.- Non-Hodgkin's Lymphoma of the Upper Digestive and Respiratory Tract: Histopathology and Implications for Treatment.- Staging in Childhood Non-Hodgkin's Lymphoma. What Are Its Benefits? How Extensive Should It Be?.- Systematic Restaging in Non-Hodgkin's Lymphoma: The Need to Define Complete Remission.- Involvement of the Nervous System in Non-Hodgkin's Lymphomas.- Leukemic (or Stage V) Lymphosarcoma.- Comments on "Clinical Aspects: Staging and Therapeutic Implications".- II: Treatment of Non-Hodgkin's Lymphomas.- Radiotherapy of Extranodal Non-Hodgkin's Lymphoma.- Evaluation and Role of Single Chemotherapeutic Agents in Adult Non-Hodgkin's Lymphoma.- General Strategy of Staging and Therapy of Non- Hodgkin's Lymphomas.- Chemotherapy in Non-Hodgkin's Malignant Lymphomas According to Potential Evolutive Groups.- BCG in the Immunotherapy of Non-Hodgkin's Malignant Lymphomas: Preliminary Results of a Controlled Trial.- Chemoimmunotherapy Versus Chemotherapy for Remission Induction in Patients With Non-Hodgkin's Lymphoma: Progress Report of a Southwest Oncology Group Study.-Complications of Total Abdominal and Spleen Irradiation in Patients With Lymphomas.- Effects of Treatment of Malignant Lymphomas on the Granulocytic Progenitor Cells (CFUc).- Preliminary Results of Chemoradiotherapy Followed (or Not) by Active Immunotherapy of Stage III and IV Lymphosarcoma and Reticulosarcoma: Correlation of the Results With WHO Categorization.- Outline of a Prospective Multicentric Study on the Clinical Significance of the Kiel Classification of Non-Hodgkin's Lymphomas.- On the Question of the Tumoricidal Dose in Non-Hodgkin's Lymphomas.- Combined Modality Therapy of Childhood Non-Hodgkin's Lymphoma.- Concluding Remarks on Malignant Lymphomas.
