Incidence of second neoplasms in patients with MALT lymphoma: No increase in risk above the background population

Au, Wing Y.; Gascoyne, Randy D.; Le, N.; Viswanatha, David S.; Klasa, Richard; Gallagher, R; Connors, John M.

doi:10.1023/a:1008328226599

Cited by 32 publications

(22 citation statements)

References 21 publications

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“…14,15,26 Because patients tend to have prolonged survival, 1 of the serious long-term morbidities is the development of a second malignancy, which in this series was 11.4%. Although some have reported a higher incidence of second malignancies (20-22%) associated with MALT lymphoma, 38,39 the relative risk was not found to be above a matched normal population in our series of patients, a finding also supported by Au et al 39 …”

Section: Discussionsupporting

confidence: 81%

Long‐term outcome in localized extranodal mucosa‐associated lymphoid tissue lymphomas treated with radiotherapy

Goda

Gospodarowicz

Pintilie

et al. 2010

Cancer

188

126

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BACKGROUND: This study was conducted to evaluate the long-term outcomes in patients with stage IE and IIE mucosa-associated lymphoid tissue (MALT) lymphomas treated with involved field radiotherapy (RT). METHODS: Between 1989 and 2004, 192 patients with stage I and II MALT lymphomas were treated. The report focuses on 167 patients who received RT. The median age of patients was 58 years with a female predominance (2:1). Presenting sites were as follows: orbital adnexa in 71 patients, salivary glands in 28 patients, stomach in 25 patients, thyroid in 21 patients, and other sites in 22 patients. The median dose to nonorbital sites was 30 grays (Gy) (range, 17.5-35 Gy) and was 25 Gy for the orbit (range, 25-35 Gy). The median follow-up was 7.4 years (range, 0.67-16.20 years). RESULTS: Complete response and complete response, unconfirmed (CR/CRu) was noted in 166 (99%) patients. The 10-year recurrence-free rate (RFR) was 76%, the disease-free survival (DFS) rate was 68%, the overall survival (OS) rate was 87%, and the cause-specific survival rate was 98%. According to presenting site, the 10-year RFR was 95% for thyroid, 92% for stomach, 68% for salivary glands, and 67% for orbit. Patients with thyroid and gastric MALTs had better outcome compared with patients with MALTs diagnosed at other sites (P ¼.004). Among those patients who achieved CR, 19% developed disease recurrence (n ¼ 31), chiefly in distant sites or untreated contralateral-paired organs. At the time of disease recurrence, 7 patients (23%) had transformed to diffuse large B-cell lymphoma, 2 of whom died of lymphoma. The 5-year OS rate after treatment failure was 83%. CONCLUSIONS: Patients with localized MALT lymphomas are reported to have excellent clinical outcome after moderate-dose RT, and some are likely cured. In the current study, thyroid and gastric MALTs were found to have significantly less risk of distant recurrence. Despite disease recurrence, the overall survival remains excellent in these patients. Cancer 2010;116:3815-24.

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Section: Discussionsupporting

confidence: 81%

Long‐term outcome in localized extranodal mucosa‐associated lymphoid tissue lymphomas treated with radiotherapy

Goda

Gospodarowicz

Pintilie

et al. 2010

Cancer

188

126

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“…Given the relatively short follow-up of our series and the long latency in developing therapy-related second cancers, a role for treatment cannot be completely ruled out. Concerning this point, it should be noted that the median follow-up of our series is longer or equal to those reported by previous studies on gastric MALT lymphoma: 17.6 months in British Columbia Cancer Agency study (8) and 36 months in the Spanish series (9). Moreover, the advanced age of MALToma patients is related to a higher incidence of solid tumors and is itself a limit to a long follow-up, if compared with epidemiologic studies in younger populations like Hodgkin's lymphoma patients (22).…”

Section: Discussionsupporting

confidence: 60%

“…However, this hypothesis has not been definitely confirmed from an epidemiologic point of view; in fact, although Zucca et al (6) found a 20% prevalence of additional neoplasms in a series of patients with low-grade gastric MALT lymphoma, in a Spanish population-based study of patients with gastric MALT lymphoma, only in the subgroup of patients under 50 years of age an excess of second cancers was close to significance (9). Some studies analyzed mixed series of MALT lymphomas including both gastric and nongastric cases; Luppi et al (7) reported 11% of additional neoplasms in a small series whereas, in a population-based study from British Columbia Cancer Agency, the incidence of second malignancies resulted to 21% without a statistically significant rate increase of cancers with respect to the background population (8).…”

Section: Discussionmentioning

confidence: 98%

“…In a recent multicenter Italian study on 208 patients, the median age at diagnosis was 64.4 years with a 5-year overall survival of 83% (21). The issue of second cancer in this lymphoma subtype has not yet been addressed; in the British Columbia Cancer Agency study, the relative rate of second malignancies for the subgroup of 95 patients with nongastric MALT lymphoma was 0.82 (8).…”

Section: Discussionmentioning

confidence: 99%

“…A high number of additional neoplasms were first described in two observational studies on patients with MALT lymphoma mainly of stomach (6,7). Successively, two population-based studies did not show a statistically significant rate increase of cancers in patients with MALT lymphomas, mainly of stomach, with respect to the background population (8,9), despite an apparently high number of second cancers.…”

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confidence: 99%

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Risk of Second Cancer in Nongastric Marginal Zone B-Cell Lymphomas of Mucosa-Associated Lymphoid Tissue: A Population-Based Study from Northern Italy

Arcaini¹,

Burcheri²,

Rossi³

et al. 2007

Clinical Cancer Research

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Purpose: The aim of this study was to define the risk of second cancer in nongastric marginal zone lymphomas of mucosa-associated lymphoid tissue (MALT). Experimental Design: We considered for the analysis 157 patients with a confirmed histology of marginal zone B-cell lymphoma of MALT, presenting with a clinically prevalent extranodal site of disease, except for stomach. All patients came from two hematologic institutions of Northern Italy. We compared the occurrence of second cancer with respect to the general population by calculating the standardized incidence ratio, with the age-and sex-specific incidence rates of a cancer registry of Northern Italy (Lombardia) as a reference. Results: A history of solid neoplasia was present in 29 (18%) patients for a total number of 30 neoplasms: 25 solid tumors, 2 hematologic diseases (1 Hodgkin's lymphoma and 1 essential thrombocythemia), and 3 nonmelanoma in situ skin cancers. In 4 patients, the site of cancer and lymphoma was the same. In 21cases the solid tumor preceded the MALToma, in 3 the neoplasm was concomitant, whereas in 6 it was subsequent. For the entire group, the standardized incidence ratio of an additional malignancy was 0.8 [95 % confidence interval (95 % CI), 0.55-1.17; P = 0.2]. After excluding nonmelanoma skin cancer, the standardized incidence ratio of a second tumor was 0.75 (95% CI, 0.5-1.12; P = 0.2). After excluding all previous malignancies, the standardized incidence ratio of a second cancer was 1.32 (95% CI, 0.69-2.55; P = 0.4). The comparison of risks between males and females was not significant in each group analysis. Conclusions: Patients with nongastric MALT lymphomas are not at increased risk for other neoplasms compared with the general population of the same geographic area.

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Incidence of secondary malignancies among patients with Waldenström macroglobulinemia: An analysis of the SEER database

Castillo

Olszewski

Hunter

et al. 2015

Cancer

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BACKGROUND: Waldenstr€ om macroglobulinemia (WM) is an indolent malignancy that predominantly affects older individuals who are at risk for secondary malignancies (SMs). The objective of this study was to characterize the incidence of SMs after a diagnosis of WM with the Surveillance, Epidemiology, and End Results (SEER) database. METHODS: With SEER-13 data (1992-2011), standardized incidence ratios (SIRs) and 95% confidence intervals (CIs) were calculated for the rates of solid and hematologic SMs in WM patients versus the general population. The analysis was stratified by age, sex, race, year of diagnosis, and latency from the WM diagnosis. RESULTS: Among 4676 patients with WM, 681 SMs were recorded. The overall SIR was 1.49 (95% CI, 1.38-1.61), and the median time to an SM was 3.7 years. The cumulative incidence of SMs was 10% at 5 years and 16% at 10 years. The risk was significantly increased for cancers of the lungs, urinary tract, and thyroid; melanoma; aggressive lymphoma; and acute leukemia. The SIR for SMs in patients with WM was increased, regardless of age, sex, race, or year of diagnosis. CONCLUSIONS: Patients with WM had a 49% higher risk of SMs than the general population. The selectively increased risk for hematologic SMs and certain solid SMs may be associated with transformation, therapy, and immune dysregulation. Cancer 2015;121:2230-6.

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Incidence of second neoplasms in patients with MALT lymphoma: No increase in risk above the background population

Abstract: The incidence of second cancers in this series is similar to previous reports. However, when compared to an age-matched population followed for the same period of time, MALToma patients do not appear to have a statistically significant increased rate of cancers.

Cited by 32 publications

References 21 publications

Long‐term outcome in localized extranodal mucosa‐associated lymphoid tissue lymphomas treated with radiotherapy

Long‐term outcome in localized extranodal mucosa‐associated lymphoid tissue lymphomas treated with radiotherapy

Risk of Second Cancer in Nongastric Marginal Zone B-Cell Lymphomas of Mucosa-Associated Lymphoid Tissue: A Population-Based Study from Northern Italy

Incidence of secondary malignancies among patients with Waldenström macroglobulinemia: An analysis of the SEER database

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