title: More than a third of non-gastric malt lymphomas are disseminated at diagnosis: a single center survey.
abstract: Mucosa-associated lymphoid tissue (MALT) lymphomas are extranodal B-cell tumors that generally follow an indolent course. The gastrointestinal tract is the most common site of MALT lymphoma, comprising 50% of all cases. The tissue lesions are often localized, have high therapeutic response rates with late relapses with a long overall survival (OS). The patients with non-gastric lesions may follow a different clinical course and many of them present with disseminated disease. This study reports a series of 51 patients with non-gastric MALT lymphoma. Twenty patients (39.2%) presented with disseminated disease, seven (13.7%) patients had two MALT mucosal sites involved and eight (15.7%) had involvement of three or more mucosal sites. At presentation, 17 (33.3%) patients had the lymph node and 12 (23.5%) the bone marrow involvement. Following various combinations of treatment, complete remission was achieved in 40 (81.6%), and partial remission in three of the 49 treated patients with no difference in response rates between different disease stages. Relapse occurred in 12/43 (27.9%) patients among whom eight (18.6%) recurred in the presenting organ system. Five patients (9.8%) died because of a rapid disease progression after a median follow-up of 56 months; two patients with primary lung lesions, 1 patient with secondary intestinal disease, and 2 patients suffered transformation to diffuse large B-cell lymphoma. No significant difference in survival was found between localized and disseminated disease (log rank 0.05, df = 1, P = 0.81). A patient age > or = 60 yr at diagnosis and presentation with the nodal disease were found to be statistically significant negative prognostic factors (P < 0.05). Median OS was not reached after 145 months of follow-up, with the estimated OS being 88% at 2 yr, and 78% at 5 yr.
authors.affiliation: Institute of Haematology Clinical Center of Serbia, Koste Todorovica 2, Belgrade, Serbia. mira1@eunet.yu
authors.forename: Mirjana
authors.initials: M
authors.lastname: Sretenovic
authors.forename: Milica
authors.initials: M
authors.lastname: Colovic
authors.forename: Gradimir
authors.initials: G
authors.lastname: Jankovic
authors.forename: Nada
authors.initials: N
authors.lastname: Suvajdzic
authors.forename: Biljana
authors.initials: B
authors.lastname: Mihaljevic
authors.forename: Natasa
authors.initials: N
authors.lastname: Colovic
authors.forename: Milena
authors.initials: M
authors.lastname: Todorovic
authors.forename: Henry Dushan E
authors.initials: HD
authors.lastname: Atkinson
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001853:Bone Marrow / Q000473:pathology; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D018442:Lymphoma, B-Cell, Marginal Zone / Q000401:mortality / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009092:Mucous Membrane / Q000473:pathology; D011379:Prognosis; D012008:Recurrence; D012074:Remission Induction; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis