Development of early gastric cancer 4 and 5 years after complete remission of Helicobacter pylori associated gastric low grade marginal zone B cell lymphoma of MALT type

Background/Aim. Bronchus-associated lymphoid tissue (BALT) lymphoma is a rare subtype of low grade marginal zone B cell lymphoma representing 10% of all MALT lymphomas. The purpose of this study was to analyze the outcome of this group of patients comparing prognostic parameters and therapy modalities. Methods. A total of eight patients with BALT lymphoma had diagnosed between January 1998 - April 2008 at the Institute of Hematology, Clinical Center of Serbia, Belgrade, and they were included in this retrospective analysis. Results. Male/female ratio was 2/6, the median age was 64 years (range 37-67 years). Six patients had nonspecific respiratory symptoms and all of them had B symptoms. The patients were seronegative for HIV, HCV and HBsAg. Three patients had Sjogren's syndrome, rheumatoid arthritis and pulmonary tuberculosis, respectively. Seven patients were diagnosed by transbronchial biopsy and an open lung biopsy was done in one patient. Patohistological findings revealed lymphoma of marginal zone B cell lymphoma: CD20+/CD10-/CD5-/CyclinD1- /CD23-/IgM- with Ki-67+<20% of all cells. According to the Ferraro staging system, five patients had localized disease (CS I-IIE) and three had stage IVE; bulky tumor mass had 3 patients. All patients had Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0 or 1. Five patients received monochemotherapy with chlorambucil and 3 were treated with CHOP regimen (cyclophosphamide, doxorubicin, vincristine and prednisone). A complete response (CR) was achieved in 5 patients and a partial response (PR) in 3 of them, treated with chlorambucil monotherapy and CHOP regimen. All patients were alive during a median follow-up period of 49 months (range 6- 110 months). Three patients relapsed after monochemotherapy into the other extranodal localization. They were treated with CHOP regimen and remained in stable PR. Conclusion. BALT lymphoma tends to be localised disease at the time of diagnosis, responds well to monochemotherapy with chlorambucil and has a favourable prognosis.

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Two Cases of Diffuse Large B-Cell Lymphomas in the Cervical Lymph Nodes in Patients with Low-Grade Gastric Marginal Zone B-Cell Lymphoma (MALT Lymphoma)

Clinical Endoscopy ◽

10.5946/ce.2013.46.3.288 ◽

2013 ◽

Vol 46 (3) ◽

pp. 288 ◽

Cited By ~ 1

Author(s):

Ji Hoon Jung ◽

Hwoon-Yong Jung ◽

Hwan Yoon ◽

Jae Kwang Lee ◽

Ji Hoon Kang ◽

...

Keyword(s):

Lymph Nodes ◽

B Cell ◽

Malt Lymphoma ◽

Marginal Zone ◽

Cell Lymphoma ◽

B Cell Lymphoma ◽

Low Grade ◽

B Cell Lymphomas ◽

Cervical Lymph Nodes ◽

Large B Cell

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Diagnosis and management of cold agglutinin disease associated with low-grade B-cell lymphoma in a patient receiving pembrolizumab for lung cancer

BMJ Case Reports ◽

10.1136/bcr-2021-243751 ◽

2021 ◽

Vol 14 (8) ◽

pp. e243751

Author(s):

Nabin Raj Karki ◽

Peyton McElhone ◽

Natasha Savage ◽

Nagla Abdel Karim

Keyword(s):

Lung Cancer ◽

B Cell ◽

Marginal Zone ◽

Cell Lymphoma ◽

B Cell Lymphoma ◽

High Titre ◽

Cold Agglutinin ◽

Low Grade ◽

Cold Agglutinin Disease ◽

Cold Room

A 65-year-old with non-small cell lung cancer developed autoimmune haemolytic anaemia while receiving pembrolizumab containing chemoimmunotherapy. Initially thought to be due to pembrolizumab induced haemolysis, he was treated with steroids, and pembrolizumab was held. Haemolysis was refractory to steroids and blood was observed to agglutinate in cold room temperatures. Cold agglutinins in high titre and monoclonal serum IgM kappa protein were detected. Bone marrow biopsy showed marginal zone lymphoma confirming low grade B-cell lymphoma causing cold agglutinin disease. B-cell depletion by rituximab stopped haemolysis, and pembrolizumab was safely continued for lung cancer.

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Iodine-131-anti-B1 radioimmunotherapy for B-cell lymphoma.

Journal of Clinical Oncology ◽

10.1200/jco.1996.14.7.1974 ◽

1996 ◽

Vol 14 (7) ◽

pp. 1974-1981 ◽

Cited By ~ 277

Author(s):

M S Kaminski ◽

K R Zasadny ◽

I R Francis ◽

M C Fenner ◽

C W Ross ◽

...

Keyword(s):

Complete Remission ◽

B Cell ◽

Cell Lymphoma ◽

B Cell Lymphoma ◽

High Rate ◽

Whole Body ◽

Hematologic Toxicity ◽

Low Grade ◽

Tracer Dose ◽

Iodine 131

PURPOSE The CD20 B-lymphocyte surface antigen expressed by B-cell lymphomas is an attractive target for radioimmunotherapy, treatment using radiolabeled antibodies. We conducted a phase I dose-escalation trial to assess the toxicity, tumor targeting, and efficacy of nonmyeloablative doses of an anti-CD20 monoclonal antibody (anti-B1) labeled with iodine-131 (131I) in 34 patients with B-cell lymphoma who had failed chemotherapy. PATIENTS AND METHODS Patients were first given tracelabeled doses of 131I-labeled anti-B1 (15 to 20 mg, 5 mCi) to assess radiolabeled antibody biodistribution, and then a radioimmunotherapeutic dose (15 to 20 mg) labeled with a quantity of 131I that would deliver a specified centigray dose of whole-body radiation predicted by the tracer dose. Whole-body radiation doses were escalated from 25 to 85 cGy in sequential groups of patients in 10-cGy increments. To evaluate if radiolabeled antibody biodistribution could be optimized, initial patients were given one or two additional tracer doses on successive weeks, each dose preceded by an infusion of 135 mg of unlabeled anti-B1 one week and 685 mg the next. The unlabeled antibody dose resulting in the most optimal tracer biodistribution was also given before the radioimmunotherapeutic dose. Later patients were given a single tracer dose and radioimmunotherapeutic dose preceded by infusion of 685 mg of unlabeled anti-B1. RESULTS Treatment was well tolerated. Hematologic toxicity was dose-limiting, and 75 cGy was established as the maximally tolerated whole-body radiation dose. Twenty-eight patients received radioimmunotherapeutic doses of 34 to 161 mCi, resulting in complete remission in 14 patients and a partial response in eight. All 13 patients with low-grade lymphoma responded, and 10 achieved a complete remission. Six of eight patients with transformed lymphoma responded. Thirteen of 19 patients whose disease was resistant to their last course of chemotherapy and all patients with chemotherapy-sensitive disease responded. The median duration of complete remission exceeds 16.5 months. Six patients remain in complete remission 16 to 31 months after treatment. CONCLUSION Nonmyeloablative radioimmunotherapy with 131I-anti-B1 is associated with a high rate of durable remissions in patients with B-cell lymphoma refractory to chemotherapy.

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EBV-positive nodal low-grade B-cell lymphoma with BCL3, IgA and IRTA1 expression: Is this a polymorphic lymphoproliferative disorder or an EBV-positive nodal marginal zone lymphoma?

Pathology International ◽

10.1111/pin.12687 ◽

2018 ◽

Vol 68 (9) ◽

pp. 538-540

Author(s):

Masakazu Fujimoto ◽

Yusuke Yamashita ◽

Hironori Haga ◽

Takashi Akasaka ◽

Yoshifumi Iwahashi ◽

...

Keyword(s):

B Cell ◽

Lymphoproliferative Disorder ◽

Marginal Zone ◽

Cell Lymphoma ◽

B Cell Lymphoma ◽

Marginal Zone Lymphoma ◽

Low Grade ◽

Nodal Marginal Zone Lymphoma

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Gastric marginal zone B-cell lymphomas of MALT type develop along 2 distinct pathogenetic pathways

Blood ◽

10.1182/blood.v99.1.3 ◽

2002 ◽

Vol 99 (1) ◽

pp. 3-9 ◽

Cited By ~ 133

Author(s):

Petr Starostik ◽

Jochen Patzner ◽

Axel Greiner ◽

Stephan Schwarz ◽

Jörg Kalla ◽

...

Keyword(s):

B Cell ◽

Lymphoid Tissue ◽

Gene Locus ◽

Marginal Zone ◽

Cell Lymphoma ◽

B Cell Lymphoma ◽

Low Grade ◽

High Grade ◽

Clonal Proliferation ◽

Large B Cell Lymphoma

Low-grade marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT) type can transform into high-grade diffuse large B-cell lymphoma (DLBCL). Up to 60% of the MALT lymphomas contain the recently described t(11;18). However, this translocation has not been detected in any DLBCL so far. To elucidate the pathogenesis of these tumors, microsatellite screening of 24 gastric MALT lymphomas was performed and the results were compared with aberrations detected in a previous study on gastric DLBCL. The most frequent aberration, found in 21% of the MALT lymphomas that were exclusively t(11;18)-negative cases, was amplification of the 3q26.2-27 region (harboring the locus of the BCL6 gene). Allelic imbalances in regions 3q26.2-27, 6q23.3-25, 7q31, 11q23-24, and 18q21 were shared by both MALT lymphoma and DLBCL. Loss of heterozygosity in regions 5q21 (APC gene locus), 9p21 (INK4A/ARF), 13q14 (RB), and 17p13(p53) and allelic imbalances in 2p16, 6p23, and 12p12-13 occurred exclusively in DLBCL. Only one of 10 t(11;18)-positive MALT lymphomas showed an additional clonal abnormality. These tumors thus display features of a clonal proliferation characterized by the presence of the t(11;18). However, they only rarely display secondary aberrations and do not seem to transform into DLBCL. In contrast, t(11;18)-negative MALT lymphomas show numerous allelic imbalances—some of them identical with aberrations seen in DLBCL—suggesting that this group is the source of tumors eventually transforming into high-grade DLBCL.

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