Gender Aspects in Extranodal Marginal Zone B-Cell Lymphoma of the Mucosa-Associated Lymphoid Tissue: Does Sex Matter?

Abstract

Objectives: Gender-related aspects have been investigated in a variety of tumor entities including results on sex-specific differences in non-Hodgkin lymphoma. However, there are no data on gender differences in mucosa-associated lymphoid tissue (MALT) lymphoma. Methods: We have analyzed 327 patients treated between 1999 and 2015 with a median follow-up time of 55.2 months. Results: There was a female predominance, with 197 female (60.2%) and 130 male patients (39.8%, female-to-male ratio 1.5). The mean age was comparable between female and male patients (61.2 vs. 61.7 years, p = 0.777). Female patients less frequently had gastric MALT lymphoma (31.5 vs. 39.2%), but this was not statistically significant (p = 0.149). Extragastric manifestations were equally distributed, except for parotid (p = 0.003) and breast lymphoma (n = 8, 100% female) showing a female predominance. This was most likely related to a higher rate of active autoimmune disorders in women (35.6 vs. 11.0%, p < 0.001). β₂-Microglobulin elevation at diagnosis occurred more often in female patients (42.8 vs. 26.0%; p = 0.008). However, this did not translate into a worse progression-free survival for female (56.0 months, 95% CI 30.1-81.9) versus male patients (49.0 months, 95% CI 25.4-72.5, p = 0.433). Overall survival did not differ between groups. Conclusion: Our data show surprisingly little differences between female and male patients with MALT lymphoma. Both sexes appeared to have well-balanced clinical features and an identical prognosis.

Prolonged follow‐up on lenalidomide‐based treatment for mucosa‐associated lymphoid tissue lymphoma (MALT lymphoma)—Real‐world data from the Medical University of Vienna

“…Furthermore, it is not feasible to draw any strong conclusions following this observation due to the limited number of cases included in this series, precluding also direct comparison of the two different treatment regimens used. The fact that also patients with localized disease had excellent outcomes is in league with other studies performed at our institution with various systemic approaches 31,37,38 and is also in line with the recommendation in guidelines that systemic therapy can also be considered in localized disease. [8][9][10] The median follow-up time (68 months) for our patient collective is comparable to a recently published analysis for R-LEN in patients with MZL from the MD Anderson, who reported on 30 patients with median follow-up of 75 months.…”

“…As already seen in other trials performed at our institution, the majority of patients had extragastric MALT lymphoma, with only 32% having gastric MALT lymphoma. However, this trend is not only seen at our institution, but also in larger international studies . Whether this reflects an increase in awareness and higher diagnostic yield in extranodal MALT lymphomas or a decline in the rate of gastric MALT lymphomas is an ongoing debate.…”

Gender-Specific Aspects in Patients with Multiple Myeloma Undergoing Autologous Stem Cell Transplantation: A Single-Center Experience

“…In addition, PFS (56.0 vs. 49.9 months, p = 0.433) and OS ( p = 0.102) did not differ between females and males [5] .…”

“…In hematologic malignancies, however, gender aspects have been investigated in mucosa-associated lymphoid tissue lymphomas [5] and in the broader cohort of nonHodgkin lymphomas [6] , where a male propensity was reported for Burkitt lymphoma, diffuse large B-cell lymphoma, and T-cell lymphomas. In terms of anti-lymphoma treatment, a recent work has described the role of sex and weight on rituximab clearance and serum elimination half-life in elderly patients.…”

Marginal zone B-cell lymphoma: lessons from Western and Eastern diagnostic approaches

“…2,5 Men and women are affected equally, although there is sitespecific female predominance, e.g., the parotid gland and breast. 2,5,6 Immunoproliferative small intestine disease (IPSID)/alpha heavy chain disease (aHCD) predominantly affects young adults with a geographic restriction to the Middle East and less commonly Far East, as well as North and South Africa.…”