Clinical, histological and molecular follow-up of 60 patients with gastric marginal zone lymphoma of mucosa-associated lymphoid tissue

Abstract Although patients with bronchus-associated lymphoid tissue (BALT) lymphoma show an indolent clinical course, appropriate disease management at diagnosis is not well defined. This study aimed to compare 3 treatment strategies for patients with BALT lymphoma: active surveillance, systemic chemotherapy or immunotherapy at diagnosis, or complete surgical resection at diagnosis. We conducted a retrospective study of all patients with new diagnoses of marginal zone lymphoma (MZL) involving the lung who were treated at the Memorial Sloan Kettering Cancer Center between 1995 and 2017. Primary BALT lymphoma was defined as disease confined to the lungs and adjacent lymph nodes. Active surveillance was defined as a documented observation plan and ≥3 months of follow-up before initiating treatment. Overall survival (OS) and event-free survival (EFS) were compared between treatment groups. We reviewed 200 consecutive patients with MZL involving the lung; 123 met the inclusion criteria and were managed by active surveillance (47%), complete surgical resection (41%), or systemic chemotherapy or immunotherapy (11%). With a median follow-up of >60 months, surgical resection was associated with a superior EFS compared with active surveillance and systemic treatment (6-year EFS: 74% vs 65% vs 62%, respectively; P = .013). Larger lesions and thrombocytopenia were associated with shorter EFS. All groups had excellent OS at 6 years (93%), albeit with a slight superiority for surgical resection (100%) over active surveillance (91%) and systemic treatment (76%) (P = .024). BALT lymphoma is an indolent disease that can often be managed expectantly and not require therapy for many years.

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Limited Role of Workup Including PET-CT, Esophagogastroduodenoscopy and Bone Marrow Biopsy in Staging of Ocular Extranodal Marginal Zone Lymphoma of Mucosa-Associated Lymphoid Tissue (MALT) Type

Blood ◽

10.1182/blood.v128.22.2988.2988 ◽

2016 ◽

Vol 128 (22) ◽

pp. 2988-2988

Author(s):

Heejung Chae ◽

Cheolwon Suh ◽

Dok Hyun Yoon ◽

Jung Yong Hong ◽

Chan-Sik Park ◽

...

Keyword(s):

Bone Marrow ◽

Bone Marrow Biopsy ◽

Malt Lymphoma ◽

Lymphoid Tissue ◽

Marginal Zone ◽

Marginal Zone Lymphoma ◽

Nodal Involvement ◽

Pet Ct

Abstract Background Lymphoma of the ocular adnexa accounts for approximately 1 to 2% of non-Hodgkin lymphomas and the most common subtype is extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT) type (80-90%). Ocular MALT lymphoma is mostly localized disease with indolent clinical course. The workup for non-gastric MALToma is usually done similar to the workup for other non-Hodgkin lymphoma. However, as there are paucity of data in the role of PET, esophagogastroduodenoscopy and bone marrow biopsy,weaimed toinvestigate these issues in patients with ocular MALT lymphoma. Patients and Method One hundred thirty patients diagnosed as ocular MALT lymphoma between Jan 2001 and Dec 2015 at a single tertiary hospital were included in this retrospective analysis. We retrospectively reviewed clinical characteristics, diagnosis, natural history of disease, treatment and outcomes. Result The median age of all patients was 48 years (range, 20-70 years). Fifty-nine (45%) were male patients. The majority of patients (n=87, 67%) presented with stage I disease, followed by bilateral involvement, defined as stage I+I (n=21, 16%), stage IV (n=16, 12%), and stage II (n=6, 5%). Nodal involvement was present in 8% (n=10), and 12% (n=16) of patents accompanied extra-nodal involvement other than orbits at initial diagnosis. Positron emission tomography (PET) had low sensitivity in detecting primary orbit lesions (n=44/120, 37%). Moreover, only in 3% of cases (n=4), PET imaging after CT scans on neck, chest, abdomen and pelvis could provide additional clinically meaningful information that led to upstaging. Accompanying gastric MALToma was found in 2% (n=2/82) of patients by EGD. Those two patients all survived until last follow-up. Bone marrow (BM) involvement was found in 6% (n=7/120). None of them had clinically significant cytopenia. With a median follow-up period of 74 months, 5-year overall survival (OS) rate was 99% in all patients. There was no significant difference in 5-year OS rates according to BM involvement (100% with and 99% without BM involvement). Conclusion PET-CT, EGD and BM biopsy has limited role in staging workup of primary ocular MALT lymphoma. Those workups should be performedonly in selected cases. Disclosures No relevant conflicts of interest to declare.

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