Early-Stage Gastric MALT Lymphoma: Is It a Truly Localized Disease?

Abstract

Section editor George P. Canellos has disclosed no financial relationships relevant to the content of this article.The content of this article has been reviewed by independent peer reviewers to ensure that it is balanced, objective, and free from commercial bias. Target audience:Physicians who wish to advance their current knowledge of clinical cancer medicine in lymphoma oncology. LEARNING OBJECTIVESAfter completing this course, the reader should be able to:1. In your patients with gastric MALT lymphoma (GML), determine accurate staging and formulate appropriate treatment strategies.2. Assess early stage GML patients who should be closely monitored for early intervention and manage treatment plans.3. Design further studies with different modality treatments to explore the impact of occult blood disease on patients' outcomes.This article is available for continuing medical education credit at CME.TheOncologist.com. CME CME ABSTRACTEarly-stage gastric mucosa-associated lymphoid tissue lymphoma (GML) is considered a localized disease with an indolent course. Circulating malignant cells have been detected in other early-stage indolent lymphomas by molecular methods. We investigated the incidence of occult blood disease in early-stage GML patients, its impact on clinical outcome, and the similarity between blood and gastric lymphocytic clones. Sixty-two patients with local-

Clonal B-cell lymphocytosis exhibiting immunophenotypic features consistent with a marginal-zone origin: is this a distinct entity?

“…25,26 To exclude this possibility in the current series, a subset of 34 cases of the present cohort were subjected to upper gastrointestinal (GI) endoscopy. All cases but one had no endoscopic or histopathological evidence of lymphoma; 21/33 cases were found with gastritis, and among them 10 were HP positive; 5 cases received HP eradication treatment and were HP negative with normal GI endoscopy on reevaluation.…”

Evaluation of the clinical characteristics and prognostic factors of gastrointestinal mucosa‐associated lymphoid tissue (MALT) lymphoma

“…Although Raderer reported that non‐gastric MALT lymphomas are significantly more prone to disseminated disease as compared with gastric MALT lymphomas, our data showed no difference between gastric and intestinal tract lymphomas (36.7% in gastric vs 30% in intestine, P = 0.575). The variations in distributions could be due to the different types of examinations and more stringent classification criteria used in different studies, since more thorough examination could lead to more precise staging …”

Early stages in the ontogeny of small B‐cell lymphomas: genetics and microenvironment

“…a and b). Considering the partial overlap with the biological profiles reported as characteristic of the various types of well‐recognized MZLs, as well as the clinical evolution patterns, we proposed that CBL‐MZ may represent: (i) the leukaemic manifestation of a pre‐existing undiagnosed lymphoma, a notion supported by anecdotal reports that MZ‐like lymphocytosis can be the presenting feature of occult gastric MALT lymphoma ; (ii) the early stage of a lymphoma with a finite chance of clinical progression; (iii) the precursor of a lymphoma, especially SMZL/SLLU, requiring additional oncogenic hits for disease progression ; (iv) a stable clonal disorder with little or no risk of evolution to lymphoma; or (v) a heterogeneous group of disorders of potential MZ origin but also unrelated entities (e.g. lymphoplasmacytic lymphoma) with overlapping features at presentation.…”