A Conconi1, S Franceschetti2, K Aprile von Hohenstaufen3, G Margiotta-Casaluci2, A Stathis3, A A Moccia3, F Bertoni4, A Ramponi5, L Mazzucchelli6, F Cavalli3, G Gaidano2, E Zucca3. 1. Division of Hematology, Department of Translational Medicine, Amedeo Avogadro University of Eastern Piedmont, A.O.U. Maggiore della Carità, Novara Hematology Unit, Department of Internal Medicine, Ospedale degli Infermi, Biella, Italy annarita.conconi@aslbi.piemonte.it. 2. Division of Hematology, Department of Translational Medicine, Amedeo Avogadro University of Eastern Piedmont, A.O.U. Maggiore della Carità, Novara. 3. Oncology Institute of Southern Switzerland (IOSI), Bellinzona. 4. Oncology Institute of Southern Switzerland (IOSI), Bellinzona Lymphoma and Genomics Research Program, Institute of Oncology Research (IOR), Bellinzona, Switzerland. 5. Institute of Pathology, A.O.U. Maggiore della Carità, Novara, Italy. 6. Lymphoma Unit, Institute of Pathology, Locarno, Switzerland.
Abstract
BACKGROUND: Histologic transformation (HT) is a poorly understood event in patients with marginal zone lymphoma (MZL). The aim of this study was to analyze incidence and risk factors for HT in a large series of MZL patients. PATIENTS AND METHODS: The studied cohort included 340 MZL patients diagnosed and treated between 1995 and 2012: 157 extranodal MZLs [mucosa-associated lymphoid tissue (MALT) lymphoma, 46%], 85 splenic MZLs (SMZLs, 25%) and 37 nodal MZLs (NMZLs, 11%). Sixty-one patients (18%) had bone marrow infiltration at presentation, with or without detectable involvement of peripheral blood, but without other involved sites; they were considered clonal B-cell lymphocytosis of marginal zone origin (CBL-MZ). RESULTS: With a median follow-up of 4.8 years, the median overall survival and progression-free survival of the whole population were 14.5 and 5 years, respectively. HT was observed in 13 cases [3.8%, 95% confidence interval (95% CI) 2%-6.5%]. Elevated lactate dehydrogenase (LDH) at diagnosis was associated with the risk of HT (P = 0.019). HT occurred in 5% of SMZLs, 4% of MALT lymphomas, 3% of NMZLs and 3% of CBL-MZ (P = 0.974). The risk of HT was 5% (95% CI 3-9%) at 5 and 10 years after diagnosis and 10% (95% CI 5%-20%) at 12 years. At the time of HT, most patients had high LDH and B symptoms. At a median follow-up of 12 months after HT, 4 of 13 patients died, all for lymphoma-related causes, with a 2-year post-transformation survival rate of 57% (95% CI 13%-86%). CONCLUSIONS: In this large retrospective series, the risk of HT across all MZL types appeared lower than the one reported for follicular lymphoma.
BACKGROUND: Histologic transformation (HT) is a poorly understood event in patients with marginal zone lymphoma (MZL). The aim of this study was to analyze incidence and risk factors for HT in a large series of MZL patients. PATIENTS AND METHODS: The studied cohort included 340 MZL patients diagnosed and treated between 1995 and 2012: 157 extranodal MZLs [mucosa-associated lymphoid tissue (MALT) lymphoma, 46%], 85 splenic MZLs (SMZLs, 25%) and 37 nodal MZLs (NMZLs, 11%). Sixty-one patients (18%) had bone marrow infiltration at presentation, with or without detectable involvement of peripheral blood, but without other involved sites; they were considered clonal B-cell lymphocytosis of marginal zone origin (CBL-MZ). RESULTS: With a median follow-up of 4.8 years, the median overall survival and progression-free survival of the whole population were 14.5 and 5 years, respectively. HT was observed in 13 cases [3.8%, 95% confidence interval (95% CI) 2%-6.5%]. Elevated lactate dehydrogenase (LDH) at diagnosis was associated with the risk of HT (P = 0.019). HT occurred in 5% of SMZLs, 4% of MALT lymphomas, 3% of NMZLs and 3% of CBL-MZ (P = 0.974). The risk of HT was 5% (95% CI 3-9%) at 5 and 10 years after diagnosis and 10% (95% CI 5%-20%) at 12 years. At the time of HT, most patients had high LDH and B symptoms. At a median follow-up of 12 months after HT, 4 of 13 patients died, all for lymphoma-related causes, with a 2-year post-transformation survival rate of 57% (95% CI 13%-86%). CONCLUSIONS: In this large retrospective series, the risk of HT across all MZL types appeared lower than the one reported for follicular lymphoma.
Authors: Max I Schreuder; Michiel van den Brand; Konnie M Hebeda; Patricia J T A Groenen; J Han van Krieken; Blanca Scheijen Journal: J Hematop Date: 2017-09-25 Impact factor: 0.196
Authors: Muhammad Husnain; Russ Kuker; Isildinha M Reis; Sunil Girish Iyer; Wei Zhao; Jennifer R Chapman; Francisco Vega; Izidore S Lossos; Juan Pablo Alderuccio Journal: Cancer Med Date: 2020-05-26 Impact factor: 4.452