Gastric low-grade B-cell MALT lymphoma: treatment, response, and genetic alteration

Nakamura, Toshiyasu; Inagaki, Hiroshi; Seto, Masao; Nakamura, Shigeo

doi:10.1007/s00535-003-1234-4

Cited by 27 publications

(14 citation statements)

References 43 publications

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“…In contrast, other reports showed a high prevalence of the translocation in patients with H. pylori-negative gastric MALT lymphoma (50-100%). (Nakamura et al 2003;Ye et al 2003;Nakamura et al 2006), which is consistent with our current study. Differences in the prevalence of the translocation in the patient groups of these studies may explain the diverse outcomes in H. pylori-negative gastric MALT lymphoma.…”

Section: Discussionsupporting

confidence: 93%

Long-Term Outcomes of Gastric Mucosa-Associated Lymphoid Tissue Lymphomas after Helicobacter pylori Eradication Therapy

Terai

Iijima

Kato

et al. 2008

Tohoku J. Exp. Med.

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Mucosa-associated lymphoid tissue (MALT) lymphomas are localized primarily in the gastrointestinal tract and are characterized by an indolent nature and favorable outcome with specifi c therapy. Gastric MALT lymphomas are closely linked to Helicobacter pylori (H. pylori) infection, for which eradication therapy is recognized as an effective primary treatment for the disease. However, there is little information about long-term outcomes after the therapy. In the present study, we elucidated the long-term outcomes of 74 patients (70 H. pylori-positive and 4 negative cases) followed up by endoscopy at least 12 months after exclusive eradication therapy alone. The median follow-up period was 46 months. When the remission status was estimated at the time point of 12 months post-eradication, the numbers of patients with complete remission (CR), histologically residual disease with macroscopic normalization (hRD), partial remission with more than 50% tumor reduction (PR) or no response (NR) were 56, 12, 2 and 4, respectively. During follow-ups of over 12 months post-eradication, 11 of the 12 hRD cases were belatedly induced to CR but one CR case histologically relapsed into hRD. One of the 2 PR cases eventually turned into hRD 20 months later. Therefore, 66 CR, 3 hRD, 1 PR, and 4 NR cases (including 3 H. pylorinegative) were identifi ed at the last follow-up of the present study. All 74 patients were followed up without any second-line therapies, but none exhibited disease progression. Thus, the long-term outcome of localized gastric MALT lymphoma after H. pylori eradication therapy was favorable. A watch and wait strategy may be a reasonable approach for hRD since the majority might be in the process of turning into delayed CR. gatric MALT lymphoma; H. pylori eradication; long-term outcome; complete remission; radiotherapy.Tohoku

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Section: Discussionsupporting

confidence: 93%

Long-Term Outcomes of Gastric Mucosa-Associated Lymphoid Tissue Lymphomas after Helicobacter pylori Eradication Therapy

Terai

Iijima

Kato

et al. 2008

Tohoku J. Exp. Med.

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“…We also established that the presence of t(11;18) is significantly correlated with unresponsiveness to H. pylori eradication. 69,70 Detection of this translocation thus has significant implication for the treatment of patients with gastric MALT lymphomas.…”

Section: Molecular Genetics Of Mucosa-associated Lymphoid Tissue Lympmentioning

confidence: 99%

Molecular pathogenesis of MALT lymphoma: two signaling pathways underlying the antiapoptotic effect of API2-MALT1 fusion protein

2006

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At least three recurrent chromosomal translocations, t(11;18)(q21;q21), t(1;14)(p22;q32), t(14;18)(q32;q21), involving the API2-MALT1 fusion protein, BCL10 and MALT1, have been implicated in the pathogenesis of mucosa-associated lymphoid tissue (MALT) lymphoma. Several lines of evidence indicated that both BCL10 and MALT1 are required for nuclear factor kappa B (NF-jB) activation by antigen receptor stimulation in lymphocytes, and API2-MALT1 can bypass this BCL10/MALT1 signaling pathway. Nuclear factor kappa B activation may contribute to antiapoptotic effect through NF-jB-mediated upregulation of apoptotic inhibitor genes. We recently demonstrated that API2-MALT1 can induce transactivation of the API2 gene through NF-jB activation, thus highlighting a positive feedback-loop mechanism of self-activation by upregulating its own expression in t(11;18) MALT lymphomas. We also demonstrated that API2-MALT1 possesses an antiapoptotic effect, in part, through its direct interaction with apoptotic regulators. These findings therefore led us to hypothesize that the antiapoptotic effect by API2-MALT1 may be mediated by its interaction with apoptotic regulators, on the one hand, and by NF-jB-mediated upregulation of apoptotic inhibitor genes on the other. We also found that BCL10 and MALT1 are shuttling between nucleus and cytoplasm, and that MALT1 can regulate the subcellular location of BCL10. Leukemia (2006) 20, 929-936.

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“…Helicobacter pylori (H. pylori) infection has been documented in up to 90% of patients with low-grade MALT lymphoma (11,18,22) . The discovery of a causative role for H. pylori in the development of gastric marginal zone lymphoma of the MALT type has dramatically altered the therapeutic approach to patients with early stage disease.…”

Section: Discussionmentioning

confidence: 99%

“…Case 5 presented a large lesion in the gastric body and was submitted to subtotal gastrectomy associated with adjuvant chemotherapy and radiotherapy. Nowadays, in the patients submitted to the curative resection of the primary gastric lymphoma in initial stage, we indicated adjuvant chemotherapy to eradicate microscopic residual disease.Helicobacter pylori (H. pylori) infection has been documented in up to 90% of patients with low-grade MALT lymphoma (11,18,22) . The discovery of a causative role for H. pylori in the development of gastric marginal zone lymphoma of the MALT type has dramatically altered the therapeutic approach to patients with early stage disease.…”

mentioning

confidence: 99%

Curative resection plus adjuvant chemotherapy for early stage primary gastric non-Hodgkin's lymphoma: a retrospective study with emphasis on prognostic factors and treatment outcome

Waisberg¹,

Andre²,

Franco

et al. 2006

Arq. Gastroenterol.

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-Background -There is controversy regarding the optimal therapy for primary non-Hodgkin gastric lymphoma with some authors defending surgical extirpation either alone or in association with radiotherapy and or chemotherapy, especially in relation to the earlier stages of the disease. Aim -To analyze the clinical-pathological features and the results of management approaches for patients with primary early-stage non-Hodgkin's lymphoma of the stomach operated in Surgical Gastroenterology Department, "Hospital do Servidor Público Estadual", São Paulo, SP, Brazil. The literature is reviewed to highlight the aspects of diagnosis, prognostic factors and role of the various treatment regimens. Method -Sixteen patients with primary early-stage gastric lymphoma underwent curative surgical treatment. The variables analyzed were age, sex, location, size, type of surgery, number of lesions, depth of invasion, histological type in accordance with Kiel's classification, involvement of lymph nodes, Ann Arbor stage classification modified by Musshoff and Schmidt-Vollmer, histological grade, margins, adjuvant therapy, clinical course and survival. Results -Ten patients (62.5%) underwent subtotal gastrectomy and six (37.5%) underwent total gastrectomy. The majority (9/56.2%) of the lesions were located in the antrum. Single lesions (10/62.5%) were more frequent than multiple lesions (6/37.5%). Thirteen patients (81.2%) were classified as stage IE and three (18.7%) as stage IIE1. Primary gastric lymphoma classified histologically as low or high grade was presented by 10 (62.5%) and 6 (37.5%) patients, respectively. The most frequent histological types were the lymphoplasmocytic cytoid (4/25.0%) and centroblastic (4/25.0%). Ten patients (62.5%) received adjuvant treatment (chemotherapy and/or radiotherapy). Nine patients (56.2%), all in stage IE, reached a survival greater than 5 years and of these eight (50.0.%) had received adjuvant therapy. Two (12.5%) patients with stage IIE1 presented peritoneal relapse and died 3.0 years and 3.5 years after their respective operations. The mean overall survival was 42,5 months. Conclusions -Among the patients with primary early-stage gastric lymphoma (IE and IIE1), the gastric resection enabled an accurate clinicopathological staging, in addition to obtaining sufficient material for histopathological study and extirpation of the lesion. Furthermore, for patients with stage IE disease, the gastric resection combined with adjuvant therapy was associated with a greater than 5-year survival. Until prospective randomized studies are realized in order to evaluate the real efficacy of the different types of treatment for primary early-stage gastric lymphoma, management approaches should be individually tailored. HEADINGS -Lymphoma. Non-Hodgkin's lymphoma. Gastric neoplasms. Prognostic factors. Survival. lymphomas, mucosa-associated lymphoid tissue (MALT) and low-grade lymphomas (12,16,27,28,31) . Due to the relative rarity of the tumor, few centers have accumulated an adequate number of pat...

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Gastric low-grade B-cell MALT lymphoma: treatment, response, and genetic alteration

Cited by 27 publications

References 43 publications

Long-Term Outcomes of Gastric Mucosa-Associated Lymphoid Tissue Lymphomas after Helicobacter pylori Eradication Therapy

Long-Term Outcomes of Gastric Mucosa-Associated Lymphoid Tissue Lymphomas after Helicobacter pylori Eradication Therapy

Molecular pathogenesis of MALT lymphoma: two signaling pathways underlying the antiapoptotic effect of API2-MALT1 fusion protein

Curative resection plus adjuvant chemotherapy for early stage primary gastric non-Hodgkin's lymphoma: a retrospective study with emphasis on prognostic factors and treatment outcome

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