Nodular non-Hodgkin's lymphoma (NHL):Factors influencing prognosis and indications for aggressive treatment

In this study we have analyzed a group of 86 consecutive previously untreated patients with nodular lymphoma in order to determine those factors which adversely effect survival. Sixty-two percent of these patients are still living; 23 patients for greater than 36 months. In contrast, 38% have died; 28% of them within 24 months of diagnosis. Striking correlations with short survival were seen with histiocytic cell type, Ann Arbor B symptoms and advanced age. Survival also declined with advanced stage but was A or B symptom dependent. The group was further subdivided into those with exclusively nodular and those with mixed nodular and diffuse histology in order to determine whether the presence of a diffuse component had a negative influence. No significant differences were found in survival patterns between these 2 groups. Our results clearly define a subgroup of nodular lymphoma patients with a poor prognosis which is likely to benefit most from aggressive treatment. The remaining patients are surviving for longer periods of time (albeit many not disease free) and the appropriate treatment for this group remains controversial.