Long-term outcome of 487 patients with early-stage extra-nodal marginal zone lymphoma

Teckie, Sewit; Qi, Shunan; Chelius, Monica; Lovie, Shona; Hsu, Meier; Noy, Ariela; Portlock, Carol S.; Yahalom, Joachim

doi:10.1093/annonc/mdx025

Cited by 69 publications

(61 citation statements)

References 19 publications

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“…DLBCL and MZL were the most frequent histopathologies of PDL within our cohort. Localized MZL and other low‐grade lymphomas are known to respond well to local treatments . Although cytoreductive surgery may appear promising in some cases of primary cerebral DLBCL, efforts aiming at the resection of DLBCL and other high‐grade lymphomas are generally discouraged .…”

Section: Discussionmentioning

confidence: 99%

Primary dural lymphomas: Clinical presentation, management, and outcome

Karschnia

Batchelor

Jordan

et al. 2020

Cancer

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BACKGROUND: Clinical experience is limited for primary central nervous system (CNS) lymphoma that arises from the dura mater, which is denoted with the term primary dural lymphoma (PDL). This study was aimed at determining the relative incidence, presentation, and outcomes of PDL. METHODS: The institutional databases of the Divisions of Neuro-Oncology at the Massachusetts General Hospital and the Yale School of Medicine were retrospectively searched for patients with primary CNS lymphoma. Patients with pathologically confirmed dural lymphoma and no evidence of primary cerebral or systemic involvement were identified. Clinical data, diagnostic findings, treatments, and outcomes were recorded. RESULTS: A total of 20 patients with PDL were identified, and they represented 6.3% of the individuals with primary CNS lymphomas (20 of 316). Histopathological examination of PDL revealed the following underlying subtypes: diffuse large B-cell lymphoma (10 of 20 patients), marginal zone lymphoma (6 of 20), follicular lymphoma (2 of 20), undefined B-cell non-Hodgkin lymphoma (1 of 20), and T-cell non-Hodgkin lymphoma (1 of 20). On imaging, all tumors appeared as extraaxial masses with avid contrast enhancement and mostly mimicked meningioma. The median apparent diffusion coefficient value was 667 ± 26 mm 2 /s. Cerebrospinal fluid analyses and symptoms were nonspecific, and the diagnosis rested on tissue analysis. Therapeutic approaches included surgery, radiotherapy, and chemotherapy. The median overall survival was not reached after 5 years. Three patients were deceased at database closure because of tumor progression. The extent of tumor resection correlated positively with overall survival (P = .044). CONCLUSIONS: PDL is a rare variant of primary CNS lymphoma that can be radiographically mistaken for meningioma. The outcome is excellent with multimodality treatment, and aggressive surgery may convey a survival advantage in select cases.

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Section: Discussionmentioning

confidence: 99%

Primary dural lymphomas: Clinical presentation, management, and outcome

Karschnia

Batchelor

Jordan

et al. 2020

Cancer

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“…Overall, the outcomes among patients with extranodal MALT lymphoma are excellent with deaths due to disease occurring only rarely (4). While relapses after initial therapy for limited stage MALT lymphoma can occur in roughly 35-60% of patients, for those with gMALT the relapse-free survival rates are superior (5)(6)(7)(8).…”

Section: Introductionmentioning

confidence: 99%

Outcomes After Reduced-Dose Intensity Modulated Radiation Therapy for Gastric Mucosa-Associated Lymphoid Tissue (MALT) Lymphoma

Pinnix

Gunther

Milgrom

et al. 2019

International Journal of Radiation Oncology*Biology*Physics

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Purpose/Objectives: In patients with gastric extranodal marginal zone lymphoma of mucosaassociated lymphoid tissue lymphoma (MALT lymphoma), the standard radiation therapy (RT) dose is ≥ 30 Gy. We report the outcome of patients treated with reduced 24 Gy compared with ≥ 30 Gy. Materials/Methods: We reviewed 32 patients diagnosed between 2007 and 2017 with gastric MALT lymphoma and treated with involved site radiation therapy (ISRT) using intensity modulated radiation therapy (IMRT). Response to therapy was based on post-RT endoscopic biopsy. Freedom from local treatment failure (FFTLF), freedom from treatment failure (FFTF), and overall survival (OS) outcomes were determined. Results: The median age of patients at diagnosis was 58 years. Antimicrobial therapy was administered to 11 patients pre-RT, with residual disease was documented in all 11patients. Rituximab (n=2) or Rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP, n=1) was administered in 3 patients pre-RT; with biopsy proven persistent disease after therapy in all 3 cases. One patient received RT (36 Gy) and concurrent rituximab. Median RT dose was 30 Gy; 30-36 Gy in 66% (n=21) and 24 Gy in 34% (n=11). Post-RT biopsy documented CR in all patients. Failures occurred in the stomach, and duodenum at 3.6 and 4.5 years, respectively, *

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“…The occurrence of DLBCL is related either to the development of DLBCL de novo or to the transformation from EMZL. According to the literature, the rate of histological transformation to a DLBCL has been reported to be in the range of 2-5% for EMZL, with the median time for transformation being 11-48 months [27][28][29][30]. Interestingly, the large majority of DLBCL following EMZL is clonallyrelated, which constitutes a real transformation between EMZL and DLBCL.…”

Section: Resultsmentioning

confidence: 99%

Diffuse large B cell lymphoma in a preceding IgG4-related disease with kidney restricted lambda light chain expression: case report and literature review

Wang

Liu

et al. 2020

BMC Nephrol

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Background: IgG4-related disease (IgG4-RD) is a newly classified but poorly understood immune-medicated systemic disease. It causes potential fibroinflammation in one or more organs, characterized by tumescent organs and marked IgG4-positive plasma cells infiltration in the affected tissues. There have been a few cases revealing close relationship between IgG4-RD and formation of B cell lymphoma. Diffuse large B cell lymphoma (DLBCL) and extranodal marginal zone lymphoma (EMZL) of mucosa-associated lymphoid tissue are the most common subtypes ever described, whereas the exact mechanism remain unclear. Case presentation: We report a 64-year old Chinese male who presented chronic kidney disease and was initially diagnosed typical IgG4-RD. Pathological findings revealed there was restricted expression of lambda light chain in the kidney. There was also elevated uptake abnormality observed in 18 F-FDG-PET/CT. Prednisone combined with oral cyclophosphamide helped the patient to get a partial remission of renal function and an obvious decrease of IgG4 level. However, he developed DLBCL 16 months after IgG4-RD diagnosis. The DLBCL is speculated to transform from a pre-existing but possible missed diagnosed EMZL. Conclusions: Concurrent IgG4-RD with kidney-origin EMZL developing DLBCL has never been reported in the literature. Clinicians should keep in mind that lymphoma may occur in IgG4-RD. The mechanism of lymphomagenesis potential in IgG4-RD needs further study.

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Long-term outcome of 487 patients with early-stage extra-nodal marginal zone lymphoma

Cited by 69 publications

References 19 publications

Primary dural lymphomas: Clinical presentation, management, and outcome

Primary dural lymphomas: Clinical presentation, management, and outcome

Outcomes After Reduced-Dose Intensity Modulated Radiation Therapy for Gastric Mucosa-Associated Lymphoid Tissue (MALT) Lymphoma

Diffuse large B cell lymphoma in a preceding IgG4-related disease with kidney restricted lambda light chain expression: case report and literature review

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