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More than a third of non‐gastric malt lymphomas are disseminated at diagnosis: a single center survey
Author(s) -
Sretenovic Mirjana,
Colovic Milica,
Jankovic Gradimir,
Suvajdzic Nada,
Mihaljevic Biljana,
Colovic Natasa,
Todorovic Milena,
Atkinson Henry Dushan E.
Publication year - 2009
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1111/j.1600-0609.2009.01217.x
Subject(s) - medicine , lymphoma , malt lymphoma , gastroenterology , gastrointestinal tract , mucosa associated lymphoid tissue , lymph node , lymphatic system , single center , disease , pathology
Mucosa‐associated lymphoid tissue (MALT) lymphomas are extranodal B‐cell tumors that generally follow an indolent course. The gastrointestinal tract is the most common site of MALT lymphoma, comprising 50% of all cases. The tissue lesions are often localized, have high therapeutic response rates with late relapses with a long overall survival (OS). The patients with non‐gastric lesions may follow a different clinical course and many of them present with disseminated disease. This study reports a series of 51 patients with non‐gastric MALT lymphoma. Twenty patients (39.2%) presented with disseminated disease, seven (13.7%) patients had two MALT mucosal sites involved and eight (15.7%) had involvement of three or more mucosal sites. At presentation, 17 (33.3%) patients had the lymph node and 12 (23.5%) the bone marrow involvement. Following various combinations of treatment, complete remission was achieved in 40 (81.6%), and partial remission in three of the 49 treated patients with no difference in response rates between different disease stages. Relapse occurred in 12/43 (27.9%) patients among whom eight (18.6%) recurred in the presenting organ system. Five patients (9.8%) died because of a rapid disease progression after a median follow‐up of 56 months; two patients with primary lung lesions, 1 patient with secondary intestinal disease, and 2 patients suffered transformation to diffuse large B‐cell lymphoma. No significant difference in survival was found between localized and disseminated disease (log rank 0.05, df = 1, P = 0.81). A patient age ≥ 60 yr at diagnosis and presentation with the nodal disease were found to be statistically significant negative prognostic factors ( P < 0.05). Median OS was not reached after 145 months of follow‐up, with the estimated OS being 88% at 2 yr, and 78% at 5 yr.