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Published in: Indian Journal of Hematology and Blood Transfusion 3/2022

26-08-2021 | Helicobacter Pylori | Original Article

Gastric MALT Lymphoma: A 8-Year Experience

Authors: Maria Eduarda Couto, Isabel Oliveira, Nelson Domingues, Luísa Viterbo, Ângelo Martins, Ilídia Moreira, Ana Espírito Santo, Sérgio Chacim, Cláudia Moreira, Dulcineia Pereira, Rui Henrique, José Mariz

Published in: Indian Journal of Hematology and Blood Transfusion | Issue 3/2022

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Abstract

Gastric mucosa-associated lymphoid tissue non-Hodgkin lymphoma (gMALT NHL) is the second most common gastrointestinal lymphoma (50% of all gastric lymphomas), being closely associated with Helicobacter pylori infection, justifying that antibiotic therapy is effective in over 75% of all cases. This is a retrospective study analyzing all adult gMALT NHL cases diagnosed and treated in a single center for 8 years, focusing on demographic features, treatment outcomes, and survival analysis. Sixty patients with a median age of 61 years (53.3% female gender) were analyzed. Most of the cases had localized disease (66.7% were Lugano stage I) and had low IPI scores (median: 1). There was a high prevalence of Helicobacter pylori infection (68.3%). Nearly 97% of the cases received treatment for the disease, a median of one line; 55% of the patients treated endured complete response after first-line therapy (mostly antibiotics). Median overall survival time and median progression-free survival time were not reached. The mean follow-up time was 81.8 months (95% CI: [73.3–90.3]). Thirty-six patients (60%) achieved a 3-year follow-up time; the mortality rate was 15% at the end of the study. Age superior to 65 years and transformation into DLBCL were statistically significant negative prognostic markers for survival in this study (p = 0.006 and p = 0.033, respectively). Our study confirms that gMALT NHL is an indolent disease with long-term survival. Many patients, however, are exposed to several treatment lines along their disease course.
Literature
1.
go back to reference Du MQ (2016) MALT lymphoma: a paradigm of NF-kB dysregulation. Semin Cancer Biol 39:49–60CrossRef Du MQ (2016) MALT lymphoma: a paradigm of NF-kB dysregulation. Semin Cancer Biol 39:49–60CrossRef
2.
go back to reference Wotherspoon AC, Ortiz-Hidalgo C, Falzon MR et al (1991) Helicobacter pylori-associated gastritis and primary B-cell gastric lymphoma. Lancet 338(8776):1175–1176CrossRef Wotherspoon AC, Ortiz-Hidalgo C, Falzon MR et al (1991) Helicobacter pylori-associated gastritis and primary B-cell gastric lymphoma. Lancet 338(8776):1175–1176CrossRef
3.
go back to reference Nakamura S, Yao T, Aoyagi K, et al. 1997 Helicobacter pylori and primary gastric lymphoma A histopathologic and immunohistochemical analysis of 237 patients. Cancer. 79(1): 3–11 Nakamura S, Yao T, Aoyagi K, et al. 1997 Helicobacter pylori and primary gastric lymphoma A histopathologic and immunohistochemical analysis of 237 patients. Cancer. 79(1): 3–11
4.
go back to reference Zucca E, Bertoni F, Roggero E et al (1998) Molecular analysis of the progression from Helicobacter pylori-associated chronic gastritis to mucosaassociated lymphoid-tissue lymphoma of the stomach. N Engl J Med 338(12):804–810CrossRef Zucca E, Bertoni F, Roggero E et al (1998) Molecular analysis of the progression from Helicobacter pylori-associated chronic gastritis to mucosaassociated lymphoid-tissue lymphoma of the stomach. N Engl J Med 338(12):804–810CrossRef
5.
go back to reference Zullo A, Hassan C, Cristofari F et al (2010) Effects of Helicobacter pylori eradication on early stage gastric mucosa-associated lymphoid tissue lymphoma. Clin Gastroenterol Hepatol 8(2):105–110CrossRef Zullo A, Hassan C, Cristofari F et al (2010) Effects of Helicobacter pylori eradication on early stage gastric mucosa-associated lymphoid tissue lymphoma. Clin Gastroenterol Hepatol 8(2):105–110CrossRef
6.
go back to reference Luminari S, Cesaretti M, Marcheselli L, et al. 2010 Decreasing incidence of gastric MALT lymphomas in the era of anti-Helicobacter pylori interventions: results from a population-based study on extranodal marginal zone lymphomas. Ann Oncol. 21(4): 855–859 Luminari S, Cesaretti M, Marcheselli L, et al. 2010 Decreasing incidence of gastric MALT lymphomas in the era of anti-Helicobacter pylori interventions: results from a population-based study on extranodal marginal zone lymphomas. Ann Oncol. 21(4): 855–859
7.
go back to reference Asano N, Iijima K, Koike T et al (2015) Helicobacter pylori -negative gastric mucosa-associated lymphoid tissue lymphomas: A review. World J Gastroenterol 21(26):8014–8020CrossRef Asano N, Iijima K, Koike T et al (2015) Helicobacter pylori -negative gastric mucosa-associated lymphoid tissue lymphomas: A review. World J Gastroenterol 21(26):8014–8020CrossRef
8.
go back to reference NCCN Clinical Practice Guidelines in Oncology. B-cell Lymphomas. Version 1.2020. January 22, 2020 NCCN Clinical Practice Guidelines in Oncology. B-cell Lymphomas. Version 1.2020. January 22, 2020
9.
go back to reference Zucca E, Arcaini L, Buske C, et al, 2020 on behalf of the ESMO Guidelines Committee. Marginal zone lymphomas: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of Oncology. 31(1): 17–29 Zucca E, Arcaini L, Buske C, et al, 2020 on behalf of the ESMO Guidelines Committee. Marginal zone lymphomas: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of Oncology. 31(1): 17–29
10.
go back to reference Capelle LG, de Vries AC, Looman CW et al (2008) Gastric MALT lymphoma: epidemiology and high adenocarcinoma risk in a nation-wide study. Eur J Cancer 44(16):2470–2476CrossRef Capelle LG, de Vries AC, Looman CW et al (2008) Gastric MALT lymphoma: epidemiology and high adenocarcinoma risk in a nation-wide study. Eur J Cancer 44(16):2470–2476CrossRef
11.
go back to reference Wundisch T, Dieckhoff P, Greene B et al (2012) Second cancers and residual disease in patients treated for gastric mucosa-associated lymphoid tissue lymphoma by Helicobacter pylori eradication and followed for 10 years. Gastroenterology 143(4):936–942CrossRef Wundisch T, Dieckhoff P, Greene B et al (2012) Second cancers and residual disease in patients treated for gastric mucosa-associated lymphoid tissue lymphoma by Helicobacter pylori eradication and followed for 10 years. Gastroenterology 143(4):936–942CrossRef
12.
go back to reference Lee SY, Kim JJ, Lee JH et al (2005) Synchronous adenocarcinoma and mucosa-associated lymphoid tissue (MALT) lymphoma in a single stomach. Jpn J Clin Oncol 35(10):591–594CrossRef Lee SY, Kim JJ, Lee JH et al (2005) Synchronous adenocarcinoma and mucosa-associated lymphoid tissue (MALT) lymphoma in a single stomach. Jpn J Clin Oncol 35(10):591–594CrossRef
13.
go back to reference Cammarota G, Larocca LM, D’Ugo D et al. 2001 Synchronous gastric adenocarcinoma and MALT lymphoma in a patient with H. pylori infection. Could the two neoplasms share a common pathogenesis? Hepatogastroenterology 48:104–6 Cammarota G, Larocca LM, D’Ugo D et al. 2001 Synchronous gastric adenocarcinoma and MALT lymphoma in a patient with H. pylori infection. Could the two neoplasms share a common pathogenesis? Hepatogastroenterology 48:104–6
14.
go back to reference Swerdlow SH, Campo E. Harris NL et al. 2017 WHO Classification of Tumors of Hematopoietic and Lymphoid Tissues. Revised 4th Edition. IARC Press: Lyon Swerdlow SH, Campo E. Harris NL et al. 2017 WHO Classification of Tumors of Hematopoietic and Lymphoid Tissues. Revised 4th Edition. IARC Press: Lyon
15.
go back to reference Rohatiner A, d’Amore F, Coiffer B et al (1994) Report on a workshop convened to discuss the pathological and staging classifications of gastrointestinal tract lymphoma. Ann Oncol 5:397–400CrossRef Rohatiner A, d’Amore F, Coiffer B et al (1994) Report on a workshop convened to discuss the pathological and staging classifications of gastrointestinal tract lymphoma. Ann Oncol 5:397–400CrossRef
16.
go back to reference Copie-Bergman C, Gaulard P, Lavergne-Slove A, Brousse N, Fléjou JF, Dordonne K, de Mascarel A, Wotherspoon AC (2003) Proposal for a new histological grading system for post-treatment evaluation of gastric MALT lymphoma. Gut 52:1656CrossRef Copie-Bergman C, Gaulard P, Lavergne-Slove A, Brousse N, Fléjou JF, Dordonne K, de Mascarel A, Wotherspoon AC (2003) Proposal for a new histological grading system for post-treatment evaluation of gastric MALT lymphoma. Gut 52:1656CrossRef
17.
go back to reference Gisbert JP, Aguado B, Luna M, et al. 2006 Gastric MALT lymphoma: clinical characteristics and prevalence of H. pylori infection in a series of 37 cases. Rev Esp Enferm Dig. 98: 655–665. Gisbert JP, Aguado B, Luna M, et al. 2006 Gastric MALT lymphoma: clinical characteristics and prevalence of H. pylori infection in a series of 37 cases. Rev Esp Enferm Dig. 98: 655–665.
18.
go back to reference Pinotti G, Zucca E, Roggero E (1997) Clinical Features, Treatment and Outcome in a Series of 93 Patients with Low-Grade Gastric MALT Lymphoma. Leuk Lymphoma 26:527–537CrossRef Pinotti G, Zucca E, Roggero E (1997) Clinical Features, Treatment and Outcome in a Series of 93 Patients with Low-Grade Gastric MALT Lymphoma. Leuk Lymphoma 26:527–537CrossRef
19.
go back to reference International Non-Hodgkin’s Lymphoma Prognostic Factors Project (1993) A predictive model for aggressive non-Hodgkin’s lymphoma. NEJM 329:987–994CrossRef International Non-Hodgkin’s Lymphoma Prognostic Factors Project (1993) A predictive model for aggressive non-Hodgkin’s lymphoma. NEJM 329:987–994CrossRef
20.
go back to reference Thieblemont C, Cascione L, Conconi A et al (2017) A MALT lymphoma prognostic index. Blood 130(12):1409–1417CrossRef Thieblemont C, Cascione L, Conconi A et al (2017) A MALT lymphoma prognostic index. Blood 130(12):1409–1417CrossRef
21.
go back to reference Alderuccio JP, Zhao W, Desai A et al (2019) Short survival and frequent transformation in extranodal marginal zone lymphoma with multiple mucosal sites presentation. Am J Hematol 94(5):585–596CrossRef Alderuccio JP, Zhao W, Desai A et al (2019) Short survival and frequent transformation in extranodal marginal zone lymphoma with multiple mucosal sites presentation. Am J Hematol 94(5):585–596CrossRef
22.
go back to reference Hong J, Cho J, Hye Ko Y et al (2019) Validation of the Marginal Zone Lymphoma International Prognostic Index. Ann Hematol 2019(98):457–464CrossRef Hong J, Cho J, Hye Ko Y et al (2019) Validation of the Marginal Zone Lymphoma International Prognostic Index. Ann Hematol 2019(98):457–464CrossRef
23.
go back to reference Tracy SI, Larson MC, Feldman AL et al (2019) The utility of prognostic indices, early events, and histological subtypes on predicting outcomes in non-follicular indolent B-cell lymphomas. Am J Hematol 94:658CrossRef Tracy SI, Larson MC, Feldman AL et al (2019) The utility of prognostic indices, early events, and histological subtypes on predicting outcomes in non-follicular indolent B-cell lymphomas. Am J Hematol 94:658CrossRef
24.
go back to reference Salar A, Domingo-Domenech E, Panizo C. et al. 2017 Long-term results of a phase 2 study of rituximab and bendamustine for mucosa-associated lymphoid tissue lymphoma. Blood. 130 (15): 1772–1774 Salar A, Domingo-Domenech E, Panizo C. et al. 2017 Long-term results of a phase 2 study of rituximab and bendamustine for mucosa-associated lymphoid tissue lymphoma. Blood. 130 (15): 1772–1774
25.
go back to reference Teixeira-Mendes LS, Attygalle A, Wotherspoon A. 2014 Helicobacter pylori infection in gastric extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT) lymphoma: a re-evaluation. Gut. 63:1526–1527 Teixeira-Mendes LS, Attygalle A, Wotherspoon A. 2014 Helicobacter pylori infection in gastric extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT) lymphoma: a re-evaluation. Gut. 63:1526–1527
26.
go back to reference Raderer M, Wohrer S, Kiesewetter B et al (2015) Antibiotic treatment as sole management of Helicobacter pylori-negative gastric MALT lymphoma: a single center experience with prolonged follow-up. Ann Hematol 94:969–973CrossRef Raderer M, Wohrer S, Kiesewetter B et al (2015) Antibiotic treatment as sole management of Helicobacter pylori-negative gastric MALT lymphoma: a single center experience with prolonged follow-up. Ann Hematol 94:969–973CrossRef
27.
go back to reference Saleem A, Qasim A, O’Connor HJ et al (2009) Pylera for the eradication for helicobacter pylori infection. Expert Rev Anti Infect Ther 7(7):793–799CrossRef Saleem A, Qasim A, O’Connor HJ et al (2009) Pylera for the eradication for helicobacter pylori infection. Expert Rev Anti Infect Ther 7(7):793–799CrossRef
28.
go back to reference Chey DW, Leontiadis GI, Howden CW, Moss SF. 2017 ACG Clinical guidelines: treatment of Helicobacter pylori infection. The American Journal of Gastroenterology. 112:212–238 Chey DW, Leontiadis GI, Howden CW, Moss SF. 2017 ACG Clinical guidelines: treatment of Helicobacter pylori infection. The American Journal of Gastroenterology. 112:212–238
29.
go back to reference Zucca E, Bertoni F. 2016 The spectrum of MALT lymphoma at different sites: biological and therapeutic relevance. Blood. 127(17): 2082–2092 Zucca E, Bertoni F. 2016 The spectrum of MALT lymphoma at different sites: biological and therapeutic relevance. Blood. 127(17): 2082–2092
30.
go back to reference Kiesewetter B, Ferreri AJM, Raderer M. 2015 Chemoimmunotherapy forMucosa-Associated Lymphoid Tissue-Type Lymphoma: A Review of the Literature. The Oncologist. 20:915–925 Kiesewetter B, Ferreri AJM, Raderer M. 2015 Chemoimmunotherapy forMucosa-Associated Lymphoid Tissue-Type Lymphoma: A Review of the Literature. The Oncologist. 20:915–925
31.
go back to reference Li X, Meng Q, Sun S et al (2017) Histological transformation from gastric mucosa-associated lymphoid tissue lymphoma to gastric diffuse large B-cell lymphoma. Oncol Lett 14:2244–2248CrossRef Li X, Meng Q, Sun S et al (2017) Histological transformation from gastric mucosa-associated lymphoid tissue lymphoma to gastric diffuse large B-cell lymphoma. Oncol Lett 14:2244–2248CrossRef
Metadata
Title
Gastric MALT Lymphoma: A 8-Year Experience
Authors
Maria Eduarda Couto
Isabel Oliveira
Nelson Domingues
Luísa Viterbo
Ângelo Martins
Ilídia Moreira
Ana Espírito Santo
Sérgio Chacim
Cláudia Moreira
Dulcineia Pereira
Rui Henrique
José Mariz
Publication date
26-08-2021
Publisher
Springer India
Published in
Indian Journal of Hematology and Blood Transfusion / Issue 3/2022
Print ISSN: 0971-4502
Electronic ISSN: 0974-0449
DOI
https://doi.org/10.1007/s12288-021-01483-0

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