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In 1982, results of a consensus study were published as the Working Formulation.[3] 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As a result, the Working Formulation has become outdated and less useful to clinicians and pathologists.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).

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