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.
Division of Hematology, IRCCS Policlinico San Matteo, University of Pavia, Viale Golgi 19, 27100 Pavia, Italy. luca.arcaini@unipv.it
Luca
L
Arcaini
Sara
S
Burcheri
Andrea
A
Rossi
Francesco
F
Passamonti
Marco
M
Paulli
Emanuela
E
Boveri
Ercole
E
Brusamolino
Ester
E
Orlandi
Alfredo
A
Molteni
Alessandro
A
Pulsoni
Maria Christina
MC
Cox
Lorella
L
Orsucci
Alberto
A
Fabbri
Maurizio
M
Frezzato
Maria Teresa
MT
Voso
Francesco
F
Zaja
Francesca
F
Montanari
Cristiana
C
Pascutto
Enrica
E
Morra
Sergio
S
Cortelazzo
Mario
M
Lazzarino
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