Molecular follow-up in gastric mucosa-associated lymphoid tissue lymphomas: early analysis of the LY03 cooperative trial.
Gastric marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT)-type can regress after anti-Helicobacter pylori treatment. The International Extranodal Lymphoma Study Group, the United Kingdom Lymphoma Group, and the Groupe d'Etude des Lymphomes de l'Adulte have conducted a trial to ascertain whether the addition of chlorambucil is of benefit after anti-H pylori therapy. At the last interim analysis, 105 (55%) of 189 patients had achieved a complete histologic remission after anti-Helicobacter therapy. To further assess the ability of treatment to eradicate the lymphoma clone, we analyzed the gastric biopsies from a subset of the patients by polymerase chain reaction (PCR) targeted to the immunoglobulin heavy chain genes as a molecular marker for minimal residual disease. Sixty-two cases were examined at diagnosis. Fifty-four cases were monoclonal by PCR. Forty-two of these patients achieved histologic complete remission (hCR) after anti-Helicobacter treatment: 34 cases underwent molecular follow-up analysis. Fifteen patients (44%) were in molecular remission with a median follow-up of 2 years after antibiotic treatment and of 1 year after the achievement of hCR. Less than half of the patients with MALT lymphoma can achieve sustained molecular remission after anti-Helicobacter therapy. The presence of molecular disease in the absence of histologic disease does not appear to be associated with histologic relapse, but, given the indolent nature of MALT lymphomas, a longer follow-up is needed.
Bertoni
Francesco
F
Department of Experimental Haematology, Barts and The London-Queen Mary's School of Medicine and Dentistry, London, United Kingdom. frbertoni@tin.it
Conconi
Annarita
A
Capella
Carlo
C
Motta
Teresio
T
Giardini
Roberto
R
Ponzoni
Maurilio
M
Pedrinis
Ennio
E
Novero
Domenico
D
Rinaldi
Paolo
P
Cazzaniga
Giovanni
G
Biondi
Andrea
A
Wotherspoon
Andrew
A
Hancock
Barry William
BW
Smith
Paul
P
Souhami
Robert
R
Cotter
Finbarr E
FE
Cavalli
Franco
F
Zucca
Emanuele
E
D018906:Antineoplastic Agents, Alkylating / Q000627:therapeutic use*; D002699:Chlorambucil / Q000627:therapeutic use*; D018572:Disease-Free Survival; D005188:False Negative Reactions; D005500:Follow-Up Studies; D016481:Helicobacter Infections / Q000188:drug therapy*; D016480:Helicobacter pylori; D006801:Humans; D007143:Immunoglobulin Heavy Chains / Q000235:genetics; D018442:Lymphoma, B-Cell, Marginal Zone / Q000188:drug therapy* / Q000235:genetics / Q000276:immunology; D018365:Neoplasm, Residual / Q000175:diagnosis; D016133:Polymerase Chain Reaction; D015203:Reproducibility of Results; D013997:Time Factors
D018906:Antineoplastic Agents, Alkylating; D007143:Immunoglobulin Heavy Chains; D002699:Chlorambucil