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

Abstract

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.

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

“…Smaller studies evaluating the risk of SMs in patients with marginal zone lymphoma have rendered mixed results. 30,31 Our study carries a series of limitations. First, some differences (eg, in the racially stratified analysis) were not significant because of large CIs, which reflected a lack of precision due to the small subgroup size.…”

“…However, whether these similarities are due to specific patterns of antigenic stimulation and/or genetic predisposition is unclear. Smaller studies evaluating the risk of SMs in patients with marginal zone lymphoma have rendered mixed results …”