In 1982, results of a consensus study were published as the Working Formulation. The Working Formulation combined results from six major classification systems into one classification.This allowed comparison of studies from different institutions and countries.Of patients with aggressive NHL, more than 50% can be cured.The vast majority of relapses occur in the first 2 years after therapy.
Patients, however, can often be re-treated with considerable success as long as the disease histology remains low grade.
Knowledge of cell surface markers and immunoglobulin and T-cell receptor gene rearrangements may help with diagnostic and therapeutic decisions.
The clonal excess of light-chain immunoglobulin may differentiate malignant from reactive cells.
As a result, the Working Formulation has become outdated and less useful to clinicians and pathologists.
Thus, European and American pathologists have proposed a new classification, the Revised European American Lymphoma (REAL) classification.[5-8] Since 1995, members of the European and American Hematopathology societies have been collaborating on a new World Health Organization (WHO) classification, which represents an updated version of the REAL system.[9,10] The WHO modification of the REAL classification recognizes three major categories of lymphoid malignancies based on morphology and cell lineage: B-cell neoplasms, T-cell/natural killer (NK)-cell neoplasms, and Hodgkin lymphoma (HL).