Because of the apparent inability to cure low-grade lymphoma patients, it is important that patients with this diagnosis are presented with the opportunity to participate in clinical trials designed to test new strategies or new agents with the goal of improving the prognosis for low-grade lymphoma.
Patients with limited (Stages I and II) disease provide the exception. They may have prolonged responses to radiation therapy .
It is well known that low-grade lymphomas may transform into more aggressive lymphomas. Therapy appropriate for the more aggressive cancer is required at that time.
Intermediate- and High-Grade These lymphomas are curable. Combination chemotherapy is almost always necessary for successful treatment.
Chemotherapy alone or abbreviated chemotherapy and radiation cure 70 to 80 percent of patients with limited (Stages I and II) intermediate-grade lymphoma. Advanced (Stages III and IV) disease can be eradicated in about 50 percent of patients. Recently, an international collaboration resulted in an index that is useful in assessing prognosis. The five factors identified—age, stage, performance status (general well-being), a blood chemistry measurement called lactate dehydrogenase, and the number of extralymphatic sites—allow a more precise assessment of prognosis.
• Patients with B cell immunoblastic lymphoma respond in a manner similar to those with intermediate-grade
large cell lymphoma. Several recent reports indicate that T cell lymphomas may be somewhat less favorable
