title: Prognostic value of translocation t(11;18) in tumoral response of low-grade gastric lymphoma of mucosa-associated lymphoid tissue type to oral chemotherapy.
abstract: OBJECTIVE
  To determine the impact of translocation t(11;18) on response to oral alkylating agents in gastric mucosa-associated lymphoid tissue lymphoma (GML).
  
  
  METHODS
  Fifty-three patients with a GML were studied. Helicobacter pylori-positive patients (n = 34) received anti-H pylori treatment and H pylori-negative patients (n = 19) or patients who failed to respond to anti-H pylori treatment received oral alkylating agents. t(11;18) was detected by reverse transcription polymerase chain reaction from frozen gastric biopsies.
  
  
  RESULTS
  t(11;18) was detected in 32% of patients. It was more prevalent in H pylori-negative as compared with H pylori-positive patients (12 of 19 v five of 34 patients; P = .0005). Among 31 H pylori-eradicated patients, t(11;18) was detected in three patients, all of whom experienced treatment failure, and it was absent in 28 patients: 21 patients (75%) were in remission and seven patients (25%) experienced treatment failure (P = .03). Among 21 patients who received an alkylating agent, t(11;18) was detected in 12 patients: five patients (42%) were in remission and seven patients (58%) experienced treatment failure. t(11;18) was absent in nine patients: eight patients (89%) were in remission and one patient (11%) experienced treatment failure by the end of treatment. Four patients in remission relapsed during follow-up (median, 7 years): they all had t(11;18). Durable remission was obtained in eight (89%) of the nine patients without t(11;18) versus one of the 12 patients (8%) with t(11;18) (P = .0003).
  
  
  CONCLUSIONS
  Presence of t(11;18) in GML is predictive of resistance to oral alkylating agents, with less than 10% of durable remission at long-term follow-up.
authors.affiliation: Service d'Hépatologie et de Gastroentérologie, Départment de pathologie et Institut National de la Santé et de la Recherche Médicale Unité 617, Hôpital Henri Mondor, 94000 Créteil, France. michalevy@free.fr
authors.forename: Michaël
authors.initials: M
authors.lastname: Lévy
authors.forename: Christiane
authors.initials: C
authors.lastname: Copie-Bergman
authors.forename: Christine
authors.initials: C
authors.lastname: Gameiro
authors.forename: Marie-Thérèse
authors.initials: MT
authors.lastname: Chaumette
authors.forename: Marie-Hélène
authors.initials: MH
authors.lastname: Delfau-Larue
authors.forename: Corinne
authors.initials: C
authors.lastname: Haioun
authors.forename: Antoine
authors.initials: A
authors.lastname: Charachon
authors.forename: François
authors.initials: F
authors.lastname: Hemery
authors.forename: Philippe
authors.initials: P
authors.lastname: Gaulard
authors.forename: Karen
authors.initials: K
authors.lastname: Leroy
authors.forename: Jean-Charles
authors.initials: JC
authors.lastname: Delchier
mesh_terms: D000328:Adult; D000368:Aged; D018906:Antineoplastic Agents, Alkylating / Q000627:therapeutic use; D002880:Chromosomes, Human, Pair 11; D002887:Chromosomes, Human, Pair 18; D005260:Female; D005500:Follow-Up Studies; D016481:Helicobacter Infections / Q000150:complications / Q000188:drug therapy; D006801:Humans; D018442:Lymphoma, B-Cell, Marginal Zone / Q000188:drug therapy / Q000235:genetics* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D011379:Prognosis; D012008:Recurrence; D013274:Stomach Neoplasms / Q000188:drug therapy / Q000235:genetics* / Q000473:pathology*; D014178:Translocation, Genetic; D016896:Treatment Outcome
chemical_list: D018906:Antineoplastic Agents, Alkylating