Nongastric marginal-zone B-cell MALT lymphoma: prognostic value of disease dissemination.
The aim of this study is to describe the clinical features and define the prognostic significance of disease dissemination in a large series of nongastric marginal-zone B-cell mucosa-associated lymphoid tissue (MALT) lymphomas. We studied 208 patients with nongastric marginal-zone B-cell MALT lymphoma diagnosed and treated from 1991 to 2004. Ninety percent of the patients had a single site of MALT involvement--skin (26%), salivary glands (18%), orbit (14%), Waldeyer's ring (13%)--and 39% and 28% had nodal involvement and bone marrow involvement, respectively. After a median follow-up of 2.7 years, the median event-free survival (EFS) time was 2.4 years, and the median overall survival (OS) time was not reached. On univariate analysis, the features significantly associated with longer EFS and OS times were the following: single MALT site involvement (OS), localized disease (EFS and OS), no nodal disease (EFS and OS), skin and orbit lymphoma (OS), and stage IV disease without bone marrow involvement (OS). On multivariate analysis, both bone marrow and nodal involvement were associated with shorter OS. This study describes the clinical features and the natural history of nongastric marginal-zone lymphomas and highlights that the dissemination to lymph nodes and bone marrow is associated with a poorer outcome.
Arcaini
Luca
L
Division of Hematology, IRCCS Policlinico San Matteo, University of Pavia, Viale Golgi 19, 27100 Pavia, Italy. luca.arcaini@unipv.it
Burcheri
Sara
S
Rossi
Andrea
A
Passamonti
Francesco
F
Paulli
Marco
M
Boveri
Emanuela
E
Brusamolino
Ercole
E
Orlandi
Ester
E
Molteni
Alfredo
A
Pulsoni
Alessandro
A
Cox
Maria Christina
MC
Orsucci
Lorella
L
Fabbri
Alberto
A
Frezzato
Maurizio
M
Voso
Maria Teresa
MT
Zaja
Francesco
F
Montanari
Francesca
F
Pascutto
Cristiana
C
Morra
Enrica
E
Cortelazzo
Sergio
S
Lazzarino
Mario
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018943:Anthracyclines / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D018951:Antigens, CD20 / Q000276:immunology; D000970:Antineoplastic Agents / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D019046:Bone Marrow Neoplasms / Q000556:secondary / Q000628:therapy; D017024:Chemotherapy, Adjuvant; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008207:Lymphatic Metastasis; D018442:Lymphoma, B-Cell, Marginal Zone / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies
D018943:Anthracyclines; D000911:Antibodies, Monoclonal; D018951:Antigens, CD20; D000970:Antineoplastic Agents