The Incidence of Composite Lymphomas: Case Studies Anddisease Management
Objectives: Composite lymphomas (CL), which are a combination of different types of lymphomas in a single patient can occur simultaneously or sequentially. Diagnosis and treatment of CL require a full range of modern approaches.
Methods: The study included 37 cases of CL (M:F=2:1), the median age of patients was 64 (38-83 years). All patients underwent a full range of diagnostic procedures, including histopathological, immunohistochemical/immunophenotypic (flow cytometry), cytogenetic/FISH, and molecular tests at the National Research Centre for Hematology, Moscow.
Results: Metachronous CL were observed in 17 cases and the most common type of the second lymphoma was diffuse large B-cell lymphoma (DLBCL) or Hodgkin's lymphoma (HL). In 30% of cases, DLBCL developed after HL therapy, and in 30% - after therapy of angioimmunoblastic T-cell lymphoma (AITL). In 20 cases of synchronous CL the most common was B-cell chronic lymphocytic leukemia (B-CLL) combined with hairy cell leukemia (HCL) - 54.5%, large granular lymphocytic leukemia, marginal zone lymphoma (MZL), follicular lymphoma, multiple myeloma, or mycosis fungoides. A combination of HL with other lymphoma was observed in 25% of cases (HL+MZL represent 60% of cases).
Conclusion: CL are excellent models for studying the complex process of tumor cells evolution during the course of the disease. Treatment of CL is a non-trivial task and aims to control both diseases.
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