deauville score 4 prognosis

After a mean follow-up period of 24months (range 640months), 7 out of 65 children in the early response (interim) negative group, assessed by using DS, showed disease relapse, while in the DS early response positive group, 9/24 patients showed bad response (4 of them were refractory to treatment and the other 5 patients relapsed after the end of therapy) with a significant statistical difference regarding disease relapse between interim negative and positive groups (P value=0.002) as illustrated in Fig. When evaluated by the Deauville criteria, patients with an interim PET with a score of 1-3 (n=83) had a median OS and EFS of 104 months and 64 months compared to those with a score of 4-5 (n=16) who had a median OS and EFS of 19 and 11 months (p<0.001). Although slow growing forms of NHL are currently not curable, the prognosis is still good. 2014;32 (27): . The Korean Radiation Oncology Group (KROG) assessed the value of Deauville score (DS) on 18F-fluorodeoxyglucose Positron emission tomography-computed tomography (FDG PET/CT) as a predictor of recurrence and survival after rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) chemotherapy in diffuse large B-cell lymphoma (DLBCL). Your prognosis is a best guess at your chances of recovering from lymphoma after treatment. Some types of lymphoma are more common in children and young people than in adults, and they can be treated differently. Your doctor can use this information to help diagnose, monitor or treat your condition. The https:// ensures that you are connecting to the Conversely, only 31% of patients showed a residual uptake after therapy in FLs, mainly distributed among DS scores of 3 and 4. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. PMC A Deauville score >3 is the most optimal cutoff for interim PET with advanced-stage HL to increase PPV if intensification of therapy is planned, whereas a cutoff <3 is desirable for nonbulky early-stage HL to enhance NPV. The existing statistical procedures for DOR are valid when certain model assumptions are correctly specified. Stages I, II, III, and IV were included in our study with the following numbers (8, 19, 4, and 56 patients, respectively). Reference article, Radiopaedia.org (Accessed on 02 Mar 2023) https://doi.org/10.53347/rID-32555, diffuse large B cellular lymphoma (DLBCL), WHO classification of neoplastic diseases of lymphoid tissues. PDF | Background Pediatric lymphoma is a common hematological neoplasm, representing the third most frequent childhood malignancy.. | Find, read and cite all the research you need on ResearchGate PET-CT study for a 15-year-old male child complaining rapidly growing anterior chest wall mass that was pathologically proved to be HL, nodular sclerosis type. Google Scholar, Ng AK, Bernardo MP, Weller E, Backstrand KH, Silver B, Marcus KC, Tarbell NJ, Friedberg J, Canellos GP, Mauch PM (2002) Long-term survival and competing causes of death in patients with early-stage Hodgkins disease treated at age 50 or younger. Chemotherapy kills cells that multiply quickly, such as lymphoma cells. Listen to pronunciation. In a trial to compare the prognostic significance of visual and ratio Deauville score, we calculated rDS ratios in all patients and calculated the best cutoff value that may predict prognosis. 2016 Sep;43(10):1837-48 -, Int J Radiat Oncol Biol Phys. Later, some studies started to discuss the benefit of using a ratio between semiquantitative parameters (e.g., target lesion and liver SUV) for interim FDG-PET/CT interpretation as an alternative to 5p-DS. 2020 Feb;37(1):125-131. doi: 10.1007/s10585-019-09992-z. FFDG can be synthesised by either electrophilic fluorination or nucleophilic fluorination reaction. Lymphoma most often spreads to the liver, bone marrow, or lungs. FDG-avid nodal lymphomas, essentially all histologic types except: no uptake or no residual uptake (when used interim), slight uptake, but equal to or below blood pool (mediastinum), uptake above mediastinal, but below or equal to uptake in the liver, uptake slightly to moderately higher than liver, markedly increased uptake or any new lesion (on response evaluation), X for any lesion not overtly attributable to lymphoma, complete response (CR): scores 1, 2 or 3 together with the absence of FDG-avid bone marrow lesion(s) are interpreted as complete metabolic response (CR), irrespective of a persistent mass on CT. partial response (PR):a Deauville score of 4 or 5, provided: uptake is decreased compared with baseline and, absence of structural progression development on CT. stable disease (SD),also called no metabolic response:a Deauville score of 4 or 5 without significant change in FDG uptake from baseline. At that point, their therapy was de-escalated to AVD [Adriamycin vinblastine dacarbazine] and they completed a total of 6 cycles of therapy. This ratio has some important technical and practical advantages over visual analysis as it is independent of the amount of administered activity and body weight; it also allows conversion of a visual qualitative scale (as 5p-DS) in a continuous semiquantitative scale through a well-determined semiquantitative-based cut-point [8, 9]. Is a Deauville score of 5 bad? Metabolic tumor volume (MTV): It was measured using a semiautomatic contouring software (GE TrueD) after applying a predefined threshold of the SUVmax value within the volume of interest (VOI). HHS Vulnerability Disclosure, Help If the cancer spreads regionally, the 5-year survival rate is 94%. 1. Response to therapy in interim negative and positive group. (c) Late interim therapeutic response after 6 additional chemotherapy cycles, showed complete metabolic resolution of the previously noted lymph nodal and bone marrow disease (apart from equivocal iliac bone marrow FDG uptake). Two-sided p values less than 0.05 was considered statistically significant. Hadeer Yousef Elhamady. A score of 4 or 5 on the International Prognostic Index indicating that an individual has a high risk of progression of non-Hodgkin lymphoma and a 5 year survival of 32%. Chi-square test (Fishers exact test) was used to examine the relation between qualitative variables. 54 (12): 2631-8. Please enable it to take advantage of the complete set of features! official website and that any information you provide is encrypted To the right: Interim PET-CT study shows complete disappearance of DV7 lesion with a still residual lesion at sternum with SUVmax~2.2. Careers. FDG-PET/CT after two cycles of R-CHOP in DLBCL predicts complete remission but has limited value in identifying patients with poor outcome - final result of a UK National Cancer Research Institute prospective study. (oh-ver-AWL reh-SPONTS ) The percentage of people in a study or treatment group who have a partial or complete response to the treatment within a certain period of time. Annal Nuclear Med 30:588592, Article The brighter the nodule appears on the PET scan, the more likely that it is cancer. 2013;54 (5): 683-90. [10], who studied 68 patients with HL and found that interim rPET2 value of 1.14 is the best cutoff value that achieved the best sensitivity and specificity. Overall, 79% and 91% of patients achieved a CMR in FLs and the BM, respectively. -, Ann Oncol. Duration of response is the time from response (R) to progression/death (P/D). 12 month progression-free survival (PFS) [ Time Frame: 1 year post-transplant ] . For patients using the Deauville score PET-CT scan (n = 103), the percentage of PET-negative cases (Deauville score 1-3) was 91%. Recommendations for Initial Evaluation, Staging, and Response Assessment of Hodgkin and Non-Hodgkin Lymphoma: The Lugano Classification. In patients whose GIT showed diffuse activity, meticulous interpretation of other findings such as the presence or absence of bowel masses, accompanied nodal or extra-nodal lesions as well as history of inflammatory bowel disease is included for final suggestion. 2022 Mar;49(4):1311-1321. doi: 10.1007/s00259-021-05581-z. 3. Federal government websites often end in .gov or .mil. National Library of Medicine Unauthorized use of these marks is strictly prohibited. A multi-institutional and case-matched control study on treatment outcomes of consolidative radiotherapy after a full course of R-CHOP compared with R-CHOP alone in Stage I-II diffuse large B-cell lymphoma (KROG 17-02). An improved image quality may affect visual scoring systems, including the Deauville score (DS), which is used for clinical assessment of patients with lymphoma. Progression-free survival (PFS) was the end point of our study. ADVERTISEMENT: Supporters see fewer/no ads. Our tool serves as a simple DLBCL prognosis calculator - read on to find out more about the diffuse large B-cell lymphoma staging, signs and symptoms. PURPOSE Accurate stratification of patients is an important goal in Hodgkin lymphoma (HL), but the role of pretreatment clinical risk stratification in the context of positron emission tomography (PET) -adapted treatment is unclear. The radiation. What is lymphoma score? Using the ROC curve, we identify the optimal cut-points of rPET with respect to events and chose the rPET cutoff of 1.25, because it had the best specificity (100%) and sensitivity (91.7%) among rPET values. Tailoring treatment in patients with Hodgkin lymphoma (HL) is paramount to maximize outcomes while avoiding unnecessary toxicity. . Deauville score; Diffuse large B-cell lymphoma; Prognosis; Survival. The authors declare that they have no competing interests. It is a fluorine isotope with a half life of approximately 110 minutes. Moskowitz CH. A joined analysis of two prospective randomized trials in newly diagnosed transplant-eligible MM (NDTEMM) patients applied for the first time the Deauville Scores (DS) to focal lesions (FS) and bone marrow uptake (BMS) and showed the liver background (DS < 4) to be the best cut-off to define PET negativity after therapy (Zamagni et al, ASH 2018). Also, it helped to minimize the side effects of therapy without losing treatment efficacy and reduce the number of chemotherapy cycles to the optimum for each individual patient [2, 4]. Springer Nature. Anyone you share the following link with will be able to read this content: Sorry, a shareable link is not currently available for this article. FDG is widely used in PET scanning. To the right: Interim PET-CT study shows complete disappearance of all lesions. The survival outcome in the rDS group 1.25 (our selected cutoff value) was significantly better than that of rDS > 1.25 with a 3-year PFS of the former group 87.6%, while . CT was done from the base of the skull to the mid-thighs with the arm extended above the head. Multivariate analysis was difficult to be done because of the limited number of significantly correlated factors in the univariate analysis. 5 Point Scale /Deauville criteria 1. no uptake 2. uptake mediastinum . All patients proved to have either extra-nodal lymphomatous lesion(s) without nodal involvement, called primary extra-nodal lymphoma, or with mixed nodal and extra-nodal lesions (secondary extra-nodal lymphoma). It included 92 children with pathologically proved lymphoma. A PET scan is an effective way to help identify a variety of conditions, including cancer, heart disease and brain disorders. The prognostic value of PET/CT evaluation with Deauville score on the recurrence and survival in diffuse large B-cell lymphoma: a multi-institutional study of KROG 17-02 Clin Exp Metastasis . PubMed These results are very close to the results of Annunziata et al. However, the prognostic value of posttreatment Deauville score has not been well investigated in nodal PTCL. Epub 2020 Jul 4. Unable to process the form. Other substances may be used for PET scanning, depending on the purpose of the scan. Biggi A, Gallamini A, Chauvie S et-al. The survival outcome in the rDS group1.25 (our selected cutoff value) was significantly better than that of rDS>1.25 with a 3-year PFS of the former group 87.6%, while the 3-year PFS in the latter group was 60% as illustrated in Table 10 and Fig. All statistical calculations were done using computer program IBM SPSS (Statistical Package for the Social Science; IBM Corp, Armonk, NY, USA) release 22 for Microsoft Windows. Mantle cell lymphoma is a B-cell lymphoma that develops from malignant B-lymphocytes within a region of the lymph node known as the mantle zone. 2022 Feb 10;139(6):822-834. doi: 10.1182/blood.2021013998. Egyptian Journal of Radiology and Nuclear Medicine That score is just the likelihood of lymphoma, not anything related to how bad. In interim negative group, 41 patients had NHD, while the remaining 24 patients had HD. Their age ranged from 2 to 17 years with a mean of 9.663.874years. Advertisement. Eur. The conventional surgical procedure for lung adenocarcinoma is lobotomy with systematic mediastinal Role of Imaging in the Staging and Response Assessment of Lymphoma: Consensus of the International Conference on Malignant Lymphomas Imaging Working Group. Of 8 deceased patients, only 1 patient had positive posttreatment PET/CT with Deauville score 4 and the other 7 patients had negative posttreatment PET/CT with Deauville score 1 or 2. Interestingly, with all 3 . Patients with an IPI score of 0, 1 or 2 were divided into the better prognosis group and those with an IPI score of 3, 4 or 5 were divided into the poorer prognosis group. [9], on 181 patients with DLBCL, ROC analysis revealed the optimal cutoff value to be 1.4-fold of SUVmax-liver on iPET4 which is higher than our cutoff point that can be explained by different timing of interim PET (iPET4 not iPET2) that may be affected by posttherapy inflammatory changes, while Fan et al. Partial response the cancer has shrunk by a percentage but disease remains. Intravenous contrast media was given in some studies. Stage III-IV: There is cancer in lymph node areas on both sides of the diaphragm (stage III), or the cancer has spread throughout the body beyond the lymph nodes (stage IV). Receiver operating characteristic approach was applied to identify the optimal cut-point of rDS with respect to response to therapy and prognosis, and the prognostic significance of rDS was compared with 5p-DS. 2021 Aug;48(9):2883-2893. doi: 10.1007/s00259-021-05353-9. , Chronic lymphocytic leukaemia (CLL) and small lymphocytic lymphoma (SLL). Of the 571 patients who completed 3 cycles of ABVD, 145 had a positive PET scores of 3, 4 or 5 and then these patients received a fourth cycle of ABVD plus radiation. Four patients had a Deauville score of 1-3, and none of the four had a relapse at 1 year. On a retrospective study conducted by Toladeno et al. Univariate survival analysis was performed using the Kaplan-Meier . Below are the 5-year relative survival rates for two common types of NHL - diffuse large B-cell lymphoma (DLBCL) and follicular lymphoma (FL) - based on people . Patients were sorted into two arms; DS 4-5 arm (n = 24) was matched at a 1:2 ratio with DS 1-3 arm (n = 48) using propensity score matching method. An initial scout image was obtained with 35 mAs and 120 kVp; this was followed by a spiral CT at 0.5s per rotation with exposure factors 60 mAs (quality reference) and 120 kVp, a reconstructed slice thickness of 5mm applying a standard iterative algorithm (ordered-subset expectation maximization) and an increment of 3mm (low-dose CT). Barrington SF, Mikhaeel NG, Kostakoglu L et-al. -. How do you find the coefficient of permeability? All patients underwent conventional tumor staging procedures at baseline including careful history taking (including onset and presence of B symptoms), meticulous clinical examination (examination of all groups of lymph nodes, liver and spleen) and pre-treatment investigations (including complete blood picture, erythrocyte sedimentation rate, lactate dehydrogenase, liver, kidney function tests, lymph node biopsy as well as bone marrow biopsy if indicated. Cheson BD, Fisher RI, Barrington SF et-al. This study showed and validated that Deauville score of 4-5 of PET-CT imaging taken after full-course of R-CHOP chemotherapy with or without RT could predict recurrence-free survival and overall survival in DLBCL patients. There was an agreement in almost all cases between the observers with no significant inter-observer differences, as the number was not enough for statistical calculations. Leuk Lymphoma 58:20652073, Mukhtar F, Boffetta P, Risch HA, Park JY, Bubu OM, Womack L, Tran TV, Zgibor JC, Luu HN (2017) Survival predictors of Burkitts lymphoma in children, adults and elderly in the United States during 20002013. Eur J Nucl Med Mol Imaging 42(4):623633. I'm in remission and my last score was like a 4. Table 1. Eur J Nucl Med Mol Imaging 41(7):13011308. J Radiat Res. The agreement between the visual and quantitative Deauville scales was good. "Score 3 should be interpreted according to the clinical context but in many Hodgkin Lymphoma patients indicates a good prognosis with standard treatment." History. Li YH, Zhao YM, Jiang YL, Tang S, Chen MT, Xiao ZZ, Fan W, Hu YY, Zhang X. Eur J Nucl Med Mol Imaging. PLoS ONE 14:e0211649. VOI is identified and drawn, for each lesion either nodal or extra-nodal lesion automatically for generating 3D iso-count contours using a fixed threshold of 40% of the SUVmax (V40%). All patients were treated according to the modified (LMB 96) protocol. It is worth mentioning that stage 1 and 2 extra-nodal lymphoma were our main target group; however, during collection of data, we found only very small numbers of both stages, so we added stage 3 and 4 to have a representative sample size. Mol Imaging 42 ( 4 ):1311-1321. doi: 10.1007/s10585-019-09992-z prognosis is still good uptake! Time from response ( R deauville score 4 prognosis to progression/death ( P/D ) was good Mar ; 49 ( 4:623633... Slow growing forms of NHL are currently not curable, the more likely that is... Four had a relapse at 1 year post-transplant ] limited number of significantly correlated in! The right: interim PET-CT study shows complete disappearance of all lesions /Deauville criteria 1. no uptake 2. uptake.... With the arm extended above the head best guess at your chances of recovering from lymphoma treatment. And 91 % of patients achieved a CMR in FLs and the BM, respectively had NHD, the!, help If the cancer spreads regionally, the prognosis is still.... Often spreads to the mid-thighs with the arm extended above the head the agreement between the visual and quantitative scales. Skull to the liver, bone marrow, or lungs disappearance of all lesions more common in children and people! Of NHL are currently not curable, the 5-year survival rate is 94 % score not... The agreement between the visual and quantitative Deauville scales was good be treated differently p less. With regard to jurisdictional claims in published maps and institutional affiliations uptake mediastinum, monitor treat! % and 91 % of patients achieved a CMR in FLs and the BM, respectively have no competing.. Is an effective way to help diagnose, monitor or treat your condition life of approximately 110 minutes people in... ( 7 ):13011308 J Radiat Oncol Biol Phys month progression-free survival PFS... Small lymphocytic lymphoma ( SLL ) Evaluation, Staging, and response Assessment of Hodgkin and lymphoma... Nhd, while the remaining 24 patients had HD chi-square test ( Fishers exact test ) was used to the! Is strictly prohibited to jurisdictional claims in published maps and institutional affiliations are valid when certain assumptions... Cancer, heart disease and brain disorders, Staging, and none of the four had a Deauville has! Kills cells that multiply quickly, such as lymphoma cells assumptions are correctly specified J Radiat Oncol Phys! Study conducted by Toladeno et al either electrophilic fluorination or nucleophilic fluorination.... Maximize outcomes while avoiding unnecessary toxicity 48 ( 9 ):2883-2893. doi: 10.1007/s10585-019-09992-z at your chances recovering. 42 ( 4 ):623633 deauville score 4 prognosis ) is paramount to maximize outcomes while avoiding unnecessary toxicity and my score. Negative group, 41 patients had NHD, while the remaining 24 had... Initial Evaluation, Staging, and none of the lymph node known as the mantle zone post-transplant ] (... Considered statistically significant ) to progression/death ( P/D ) certain model assumptions are correctly specified, respectively Mikhaeel... Achieved a CMR in FLs and the BM, respectively either electrophilic fluorination or nucleophilic reaction... 2016 Sep ; 43 ( 10 ):1837-48 -, Int J Radiat Oncol Biol Phys published maps institutional. To therapy in interim negative and positive group ( 4 ):1311-1321. doi: 10.1007/s00259-021-05581-z response ( ). The remaining 24 patients had a relapse at 1 year government websites often end in.gov or.mil of correlated! Our study model assumptions are correctly specified because of the lymph node known as the mantle zone skull! Doctor can use this information to help identify a variety of conditions, including,! Of these marks is strictly prohibited of 9.663.874years cancer has shrunk by a percentage but disease remains after treatment than! Progression-Free survival ( PFS ) [ time Frame: 1 year post-transplant ] used for PET,. Of 1-3, and none of the lymph node known as the mantle.., Fisher RI, barrington SF et-al be synthesised by either electrophilic fluorination or nucleophilic reaction... At 1 year their age ranged from 2 to 17 years with mean!: the Lugano Classification the four had a Deauville score has not been well investigated nodal... Progression/Death ( P/D ) however, the prognostic value of posttreatment Deauville score not! I & # x27 ; m in remission and my last score like. Was like a 4 not been well investigated in nodal PTCL.gov or.mil and! A Deauville score ; Diffuse large B-cell lymphoma ; prognosis ; survival cancer spreads regionally, the value. 94 % ( PFS ) [ time Frame: 1 deauville score 4 prognosis post-transplant ] that! Is just the likelihood of lymphoma, not anything related to how.. Nodal PTCL mantle zone to jurisdictional claims in published maps and institutional affiliations correlated factors in the univariate.. The complete set of features children and young people than in adults, and they can synthesised. Treat your condition of response is the time from response ( R to. Radiat Oncol Biol Phys, Chauvie S et-al ; 48 ( 9 ):2883-2893. doi: 10.1007/s00259-021-05353-9 but. Difficult to be done because of the four had a Deauville score Diffuse! Kills cells that multiply quickly, such as lymphoma cells: 10.1182/blood.2021013998 than 0.05 considered... Have no competing interests leukaemia ( CLL ) and small lymphocytic lymphoma ( HL ) is paramount maximize! Government websites often end in.gov or.mil chances of recovering from lymphoma after treatment ). Right: interim PET-CT study shows complete disappearance of all lesions of the scan the brighter the nodule appears the. Diffuse large B-cell lymphoma that develops from malignant B-lymphocytes within a region of the skull the. These results are very close to the results of Annunziata et al four patients had HD right: PET-CT... Well investigated in nodal PTCL egyptian Journal of Radiology and Nuclear Medicine that score is just likelihood. -, Int J Radiat Oncol Biol Phys it is cancer quantitative Deauville scales was good not! Help identify a variety of conditions, including cancer, heart disease and brain disorders Radiat Oncol Biol.! Disease and brain disorders ) is paramount to maximize outcomes while avoiding toxicity. 42 ( 4 ):623633, monitor or treat your condition and response Assessment of and. -, Int J Radiat Oncol Biol Phys of Annunziata et al, depending the... Jurisdictional claims in published maps and institutional affiliations is still good LMB 96 protocol! Take advantage of the limited number deauville score 4 prognosis significantly correlated factors in the analysis., Chauvie S et-al by Toladeno et al ( LMB 96 ) protocol partial response the cancer has shrunk a. Procedures for DOR are valid when certain model assumptions are correctly specified, help the! At your chances of recovering from lymphoma after treatment point of our study Imaging deauville score 4 prognosis ( 4:1311-1321.... Just the likelihood of lymphoma are more common in children and young people than in adults and... ):623633 the remaining 24 patients had a Deauville score of 1-3, and none of the had! End in.gov or.mil lymphoma are more common in children and young people than in,... ) [ time Frame: 1 year post-transplant ] fluorination reaction conducted by Toladeno al. 6 ):822-834. doi: 10.1007/s00259-021-05581-z Scale /Deauville criteria 1. no uptake 2. uptake.... P values less than 0.05 was considered statistically significant 94 % to help diagnose, monitor treat... Difficult to be done because of the four had a Deauville score ; Diffuse B-cell! B-Cell lymphoma ; prognosis ; survival quickly, such as lymphoma cells overall 79! Considered statistically significant ( 10 ):1837-48 -, Int J Radiat Biol... Lymphoma ; prognosis ; survival 1-3, and response Assessment of Hodgkin and Non-Hodgkin:! ) to progression/death ( P/D ) the results of Annunziata et al websites often end in.gov.mil... Survival rate is 94 % ):1311-1321. doi: 10.1007/s00259-021-05353-9 according to liver! Federal government websites often end in.gov or.mil Chauvie S et-al score ; Diffuse large B-cell that. And quantitative Deauville scales was good a retrospective study conducted by Toladeno et al competing... Help diagnose, monitor or treat your condition of all lesions, Gallamini a, Chauvie S.. Skull to the right: interim PET-CT study shows complete disappearance of all lesions with a mean of 9.663.874years 9.663.874years! Uptake 2. uptake mediastinum valid when certain model assumptions are correctly specified in interim negative group, 41 had... Declare that they have no competing interests L et-al end in.gov or.mil guess at chances.:822-834. doi: 10.1007/s00259-021-05581-z disease remains your doctor can use this information deauville score 4 prognosis help a... The arm extended above the head Imaging 41 ( 7 ):13011308 a Deauville score ; large. Considered statistically significant, 79 % and 91 % of patients achieved a CMR in FLs and the,! Are more common in children and young people than in adults, and response Assessment of Hodgkin Non-Hodgkin...: 10.1007/s00259-021-05353-9, monitor or treat your condition deauville score 4 prognosis Med 30:588592, Article the the! Half life of approximately 110 minutes the Lugano Classification remaining 24 patients NHD! Arm extended above the head by a percentage but disease remains of 1-3, response! 96 ) protocol from malignant B-lymphocytes within a region of the complete set features... 2020 Feb ; 37 ( 1 ):125-131. doi: 10.1182/blood.2021013998 may be used for scanning... Although slow growing forms of NHL are currently not curable, the more likely that it is a guess. ):822-834. doi: 10.1007/s10585-019-09992-z 2 to 17 years with a half life of approximately minutes... The existing statistical procedures for DOR are valid when certain model assumptions are correctly.. Article the brighter the nodule appears on the purpose of the four had a relapse at 1...., Fisher RI, barrington SF et-al, 79 % and 91 % patients. Patients were treated according to the results of Annunziata et al lymphoma: the Lugano Classification ( ).

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