title: Multiple lymphomatous polyposis of the gastrointestinal tract: prospective clinicopathologic study of 31 cases. Groupe D'étude des Lymphomes Digestifs.
abstract: OBJECTIVE
  Multiple lymphomatous polyposis (MLP) is an uncommon type of gastrointestinal lymphoma. The aim of this study was to analyze the clinicopathologic features and outcome of a large series of patients.
  
  
  METHODS
  From 1984 to 1995, 31 patients were enrolled prospectively. Exhaustive staging and immunohistochemical analysis were performed. The first 10 patients were treated with cyclophosphamide-vincristine-prednisolone (COP) and the subsequent 21 with doxorubicin-teniposide-cyclophosphamide-prednisolone (AVmCP). Eleven patients were treated with high-dose radiochemotherapy and stem cell autotransplantation because of partial response or relapse.
  
  
  RESULTS
  Advanced age and multiple polyps involving several gastrointestinal segments characterized initial clinical presentation. The typical tumor cell phenotype (pan-B+, CD5+, and CD10-) along with Bcl-1 rearrangement indicated that MLP is the gastrointestinal counterpart of mantle cell lymphoma. After COP treatment, only 3 patients achieved partial remissions, whereas 80% of patients after AVmCP treatment achieved complete or good partial remission. High-dose radiochemotherapy changed partial into complete remission in 80% of cases. None of the initial 10 patients survived for 3 years, but the expected 5-year survival rate was 59% in patients receiving the anthracycline-containing regimen (P < 0.0001).
  
  
  CONCLUSIONS
  MLP is a distinct entity among gastrointestinal lymphomas. An anthracycline-containing multidrug regimen and high-dose radiochemotherapy supported by autotransplantation seem to improve its poor prognosis.
authors.affiliation: Department of Gastroenterology, Hôtel-Dieu, Paris, France.
authors.forename: A
authors.initials: A
authors.lastname: Ruskoné-Fourmestraux
authors.forename: A
authors.initials: A
authors.lastname: Delmer
authors.forename: A
authors.initials: A
authors.lastname: Lavergne
authors.forename: T
authors.initials: T
authors.lastname: Molina
authors.forename: N
authors.initials: N
authors.lastname: Brousse
authors.forename: J
authors.initials: J
authors.lastname: Audouin
authors.forename: J C
authors.initials: JC
authors.lastname: Rambaud
mesh_terms: D000328:Adult; D000368:Aged; D015703:Antigens, CD / Q000032:analysis; D000951:Antigens, Neoplasm / Q000032:analysis; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000032:analysis; D003520:Cyclophosphamide / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000188:drug therapy / Q000276:immunology / Q000473:pathology*; D006801:Humans; D006854:Hydrocortisone / Q000008:administration & dosage; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000188:drug therapy / Q000276:immunology / Q000473:pathology*; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage; D008775:Methylprednisolone / Q000008:administration & dosage; D008875:Middle Aged; D009367:Neoplasm Staging; D011127:Polyps / Q000188:drug therapy / Q000276:immunology / Q000473:pathology*; D011239:Prednisolone / Q000008:administration & dosage; D011446:Prospective Studies; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D015703:Antigens, CD; D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011239:Prednisolone; D006854:Hydrocortisone; D008775:Methylprednisolone; D008727:Methotrexate