High Relapse Rate in Patients with MALT Lymphoma Warrants Lifelong Follow-up

• Published in: Clinical cancer research Vol. 11; no. 9; pp. 3349 - 3352
• Main Authors: RADERER, Markus, STREUBEL, Berthold, WOEHRER, Stefan, PUESPOEK, Andreas, JAEGER, Ulrich, FORMANEK, Michael, CHOTT, Andreas
• Format: Journal Article
• Language: English
• Published: Philadelphia, PA American Association for Cancer Research 01.05.2005
• Subjects: Adult; Aged; Aged, 80 and over; Antineoplastic agents; Biological and medical sciences; Chromosomes, Human, Pair 11 - genetics; Chromosomes, Human, Pair 18 - genetics; Chromosomes, Human, Pair 4 - genetics; Combined Modality Therapy; Female; follow-up; Follow-Up Studies; Hematologic and hematopoietic diseases; Humans; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Lymphoma, B-Cell, Marginal Zone - genetics; Lymphoma, B-Cell, Marginal Zone - pathology; Lymphoma, B-Cell, Marginal Zone - therapy; Male; MALT lymphoma; Medical sciences; Middle Aged; Neoplasm Recurrence, Local - therapy; Pharmacology. Drug treatments; relapse; Retrospective Studies; Time Factors; Translocation, Genetic; Human; Relapse; MALT lymphoma; Lymphoproliferative syndrome; Patient; Malignant hemopathy; Non Hodgkin lymphoma
• ISSN: 1078-0432; 1557-3265
• DOI: 10.1158/1078-0432.CCR-04-2282

Background: B-cell lymphoma of the mucosa-associated lymphoid tissue (MALT lymphoma) is thought to be an indolent disease, with a good prognosis following various forms of treatment. Little, however, is known about the rate and pattern of relapse following successful treatment. Patients and Methods: We have analyzed time to and pattern of relapse in patients with MALT lymphoma, along with investigation of t(11;18)(q21;q21), t(1;14)(p22;q32), and t(14;18)(q32;q21) involving IGH/MALT1 , trisomy 3, and trisomy 18. Eighty-six patients achieving complete remission (CR) after initial therapy with sufficient follow-up data were available. Primary site of disease was the stomach ( n = 36), salivary gland ( n = 19), ocular adnexa/orbit ( n = 12), lung ( n = 8), thyroid ( n = 5), breast ( n = 3), liver ( n = 2), and skin ( n = 1). Results: Thirty-two patients (37%) relapsed between 14 and 307 months (median 47 months) after initial CR. Ten relapses were local, whereas the remaining patients relapsed in a distant organ. Eight of 36 gastric versus 24 of 50 nongastric MALT lymphomas ( P = 0.02) relapsed. Five patients had a second recurrence 26 to 56 months after a second CR. Relapse rates were not related to forms of initial treatment. Chromosomal aberrations were detected in 14 of 28 (50%) relapsing patients, and chromosomal alterations were identical at diagnosis and relapse. No significant association of any of the genetic changes investigated with relapse was found. Interestingly, patients with t(11;18)(q21;q21) had a significantly longer median time to relapse (76 months) than patients without this translocation (29 months; P = 0.012). Conclusions: In view of the late relapses seen in our series, lifelong observation of all patients treated for MALT lymphoma seems to be required.