Treatment of t(11;18)-positive gastric mucosa-associated lymphoid tissue lymphoma with rituximab and chlorambucil: clinical, histological, and molecular follow-up.
Translocation t(11;18) is a factor predictive of poor response to treatment of gastric marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT). We treated 13 patients with t(11;18)-positive gastric MALT lymphoma with the combination of rituximab and chlorambucil (nine patients as first treatment and four as second line therapy). The response to treatment was assessed on endoscopy, histology and molecular parameters including clonality and t(11;18) (median follow-up: 2 years). Macroscopic lesions disappeared in all cases. Histological remission was observed in 100% of the patients at the end of follow-up. At week 25, B cell monoclonality and t(11;18)-positive tumor cells were still detected in 77% and 73%, respectively. However, at long term follow-up, the tumor B cell clone was present in only 30% whereas the t(11;18) was still detected in 70%. The combination of rituximab - chlorambucil is highly effective in t(11;18)-positive gastric MALT lymphoma. Molecular disease persists despite histological remission. t(11;18) is more sensitive than B cell clonality for the monitoring of residual molecular disease.
Lévy
Michaël
M
Service d'Hépatologie et de Gastroentérologie, APHP, Groupe hospitalier Henri Mondor - Albert Chenevier, Créteil, France. michalevy@free.fr
Copie-Bergman
Christiane
C
Molinier-Frenkel
Valérie
V
Riou
Audrey
A
Haioun
Corinne
C
Gaulard
Philippe
P
Delfau-Larue
Marie-Hélène
MH
Sobhani
Iradj
I
Leroy
Karen
K
Delchier
Jean-Charles
JC
D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal / Q000008:administration & dosage; D058846:Antibodies, Monoclonal, Murine-Derived; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002699:Chlorambucil / Q000008:administration & dosage; D002880:Chromosomes, Human, Pair 11 / Q000235:genetics; D002887:Chromosomes, Human, Pair 18 / Q000235:genetics; D005260:Female; D005500:Follow-Up Studies; D005753:Gastric Mucosa / Q000187:drug effects* / Q000378:metabolism / Q000382:microbiology; D016481:Helicobacter Infections / Q000188:drug therapy / Q000235:genetics / Q000382:microbiology; D016480:Helicobacter pylori / Q000187:drug effects; D006801:Humans; D007150:Immunohistochemistry; D019394:Ki-67 Antigen / Q000032:analysis; D018442:Lymphoma, B-Cell, Marginal Zone / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology; D008297:Male; D008875:Middle Aged; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000032:analysis; D000069283:Rituximab; D014178:Translocation, Genetic; D016896:Treatment Outcome
D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D019394:Ki-67 Antigen; D019253:Proto-Oncogene Proteins c-bcl-2; D002699:Chlorambucil; D000069283:Rituximab