The causes of death and postmortem findings in patients treated for non-Hodgkin's lymphoma at a single institution over a 13-year period were reviewed. Postmortem examination (70% of the entire sample) revealed evidence of lymphoma in 67 of 80 patients. The most frequent extranodal sites of involvement were the respiratory tract, bone marrow, liver, kidney, and gastrointestinal tract in that order. The most common cause of death was infection (33% of cases). Predisposing factors for infection included the underlying disease, (i.e., lymphomatous infiltration of organ systems) and granulocytopenia secondary to combination chemotherapy. Other causes of death included hemorrhage and respiratory failure secondary to lymphomatous infiltration of the lung. Despite advances in therapy and supportive care of patients with non-Hodgkin's lymphoma, many patients still die of this disease or of sequelae related to its treatment.
Cancer 48:779-782, 1981.
DVANCES I N THE TREATMENT of non-Hodg-
A kin's lymphoma have resulted in complete response rates of 5% or more, and many responders enjoy prolonged r e m i ~s i o n . ~, ~~ Combination chemotherapy, used in patients with advanced disease, contributes to complications such as thrombocytopenia and granulocytopenia, which predispose patients to hemorrhage and infection. Infection has been reported as the most common cause of death.3,6 Advances in supportive care including the use of empiric antibiotic therapy and platelet transfusions are useful in the treatment of complications that patients experience while on chemotherapy .lJS Despite advances in treatment and supportive care, an estimated 12,300 people died of this disease in 1979.2 Presumably, the most common causes of death in patients with lymphoma are either directly diseaserelated or secondary to complications of the therapy of the disease.
This paper analyzes the causes of death in our patient population and correlates the causes with postmortem findings wherever possible.
Methods
Patient Selection
The charts of 130 patients of the Baltimore Cancer Research Program (BCRP) who had biopsy-proven