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Prognostic Value of DNA/RNA Flow Cytometry of B‐Cell Non‐Hodgkin's Lymphoma: Development of Laboratory Model and Correlation with Four Taxonomic Systems a

Non-Hodgkin’s lymphomas are conventionally diagnosed and classified by morphological criteria, and much effort has been put into the development of taxonomic systems based on these criteria. Four different systems are presently being used, i.e. Rappaport’s, Lukes’ and Collins’, the Kiel classification, and the “Working Formulation.”’ The reproducibility of the subtypes identified, comparability of different systems with each other, and prognostic value of these classifications, however, have been questioned.’ In addition, interand intra-observer variability add to the uncertainties associated with morphological approaches to a group of diseases characterized by lymphoid cell populations of not always dissimilar morphological appearance. Immunological studies have greatly expanded our understanding of lymphoma biology but are of limited value in classifying this disease. In this study, diagnostic lymph node biopsies from 96 patients with nonHodgkin’s lymphomas of B-cell type have been analyzed by several quantitative cytometric techniques in an attempt to characterize disease based on biological cell features, to correlate these with morphological classification systems, and to investigate their prognostic value. These techniques include multi-parameter acridine orange flow cytometry for the simultaneous determination of cellular DNA and RNA content, which allows us to analyze cell cycle distribution, DNA stemline, and RNA content; autoradiographic[’H] thymidine labeling index for the determination of the number of cells synthesizing DNA, and cell volume measurements using the Coulter counter. Several papers have investigated the importance of pretreatment proliferative parameters on survival of patients. The most widely used parameter was the S phase labeling but more recently, cytometric’O and flow cytometric