Assessment of Disease Dissemination in Gastric Compared With Extragastric Mucosa-Associated Lymphoid Tissue Lymphoma Using Extensive Staging: A Single-Center Experience

Abstract

Our findings suggest that MALT lymphoma frequently presents as a multifocal disease. Extragastric MALT lymphomas are significantly more prone to dissemination than gastric MALT lymphomas.

Rituximab plus subcutaneous cladribine in patients with extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue: a phase II study by the Arbeitsgemeinschaft Medikamentose Tumortherapie

“…2,3 Efficacy data for both rituximab and cladribine are available for B-cell neoplasms and some limited data have also been reported for MALT lymphoma. [5][6][7] Cladribine is a potent purine nucleoside analogue with cytotoxic effects on both dividing and non-dividing lymphocytes.…”

“…Given that a significantly higher rate of multiorgan involvement had been previously demonstrated in non-gastric MALT lymphomas, one might speculate that this characteristic could have been responsible for the lower response rate in non-gastric MALT lymphomas. 2 In addition, systemic pretreatment did not appear to be a negative predictor of lymphoma response, because both pretreated and untreated patients had identical overall response rates (8/10 pretreated patients versus 24/30 untreated patients).…”

“…7/19 patients) does not appear to be improved when compared to that in our initial study, in which 45% of patients with non-gastric MALT lymphomas achieved a CR. As already discussed in the literature, 2,5 there are various possible explanations for the apparently superior results in gastric MALT lymphomas including a different biology due to pathogenic mechanisms such as HP infection in gastric MALT lymphomas versus autoimmune diseases in non-gastric MALT lymphomas. In addition, it can be speculated that the routine histological assessment of treatment responses in gastric MALT lymphoma might allow a more exact evaluation than radiological methods, which could lead to underreporting of CR due to remnants of scar tissue in, for example, the lung, orbit or lymph nodes.…”

“…While initially thought to be a strictly localized disease in the majority of patients, recent findings have shown a relatively high rate of multiorgan involvement as well as (systemic) relapses following local therapy. 2,3 While systemic treatment approaches had been reserved for patients with disseminated disease in the past, recent years have seen an increased number of trials using systemic approaches also in localized disease, probably because of the biological properties of MALT lymphoma. With regards to the most common localization, i.e.…”

Marginal zone lymphomas

“…17,[26][27][28] Patients with extranodal and nodal MZL had a comparable survival, but in subgroup univariate analysis, the presence of bone marrow or lymph node involvement in patients with extranodal MZL projected a lower survival rate. This finding is similar to the findings of Zucca et al 17 Although previous studies indicate nodal MZL has a worse prognosis when compared with other types of MZL, 18,29,30 on both univariate and multivariate analysis, patients with nodal MZL in this study had no significant difference in OS or RFS compared with patients with extranodal MZL.…”