Splenectomy influences bone marrow infiltration in patients with splenic marginal zone cell lymphoma with or without villous lymphocytes

Franco, Vito; Florena, Ada Maria; Stella, Mario; Rizzo, Aroldo; Iannitto, Emilio; Quintini, Gerlando; Campesi, G

doi:10.1002/1097-0142(20010115)91:2<294::aid-cncr1001>3.0.co;2-w

Cited by 56 publications

(24 citation statements)

References 47 publications

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“…11,17,21 It has been shown that the extent of bone marrow infiltration by lymphoma may increase after splenectomy. 22 As in previous reports, this study highlights that splenectomy is related to better OS and CSS as determined with univariate analysis. In multivariate analysis, however, splenectomy did not retain an independent prognostic value.…”

Section: Discussionsupporting

confidence: 81%

Splenic marginal zone lymphoma: a prognostic model for clinical use

Arcaini

Lazzarino

Colombo

et al. 2006

Blood

211

172

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The Integruppo Italiano Linfomi (IIL) carried out a study to assess the outcomes of splenic marginal zone lymphoma and to identify prognostic factors in 309 patients. The 5-year cause-specific survival (CSS) rate was 76%. In univariate analysis, the parameters predictive of shorter CSS were hemoglobin levels below 12 g/dL (P < .001), albumin levels below 3.5 g/dL (P ‫؍‬ .001), International Prognostic Index (IPI) scores of 2 to 3 (P < .001), lactate dehydrogenase (LDH) levels above normal (P < .001), age older than 60 years (P ‫؍‬ .01), platelet counts below 100 000/ L (P ‫؍‬ .04), HbsAg-positivity (P ‫؍‬ .01), and no splenectomy at diagnosis (P ‫؍‬ .006). Values that maintained a negative influence on CSS in multivariate analysis were hemoglobin level less than 12 g/dL, LDH level greater than normal, and albumin level less than 3.5 g/dL. Using these 3 variables, we grouped patients into 3 prognostic categories: low-risk group (41%) with no adverse factors, intermediate-risk group (34%) with one adverse factor, and high-risk group (25%) with 2 or 3 adverse factors.

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Section: Discussionsupporting

confidence: 81%

Splenic marginal zone lymphoma: a prognostic model for clinical use

Arcaini

Lazzarino

Colombo

et al. 2006

Blood

211

172

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“…The pattern of infiltration is typically intrasinusoidal and with the progression of the disease, especially after splenectomy, becomes nodular. 19 In advanced cases, the combination of intrasinusoidal and nodular infiltration is highly characteristic, although not entirely specific. 20 Frequently the follicles in the BM show a preserved germinal center surrounded by a rim of MZ cells.…”

Section: Bm Aspirate and Histologymentioning

confidence: 99%

Splenic marginal zone lymphoma proposals for a revision of diagnostic, staging and therapeutic criteria

et al. 2007

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Since the initial description of splenic marginal zone lymphoma (SMZL) in 1992, an increasing number of publications have dealt with multiple aspects of SMZL diagnosis, molecular pathogenesis and treatment. This process has identified multiple inconsistencies in the diagnostic criteria and lack of clear guidelines for the staging and treatment. The authors of this review have held several meetings and exchanged series of cases with the objective of agreeing on the main diagnostic, staging and therapeutic guidelines for patients with this condition. Specific working groups were created for diagnostic criteria, immunophenotype, staging and treatment. As results of this work, guidelines are proposed for diagnosis, differential diagnosis, staging, prognostic factors, treatment and response criteria. The guidelines proposed here are intended to contribute to the standardization of the diagnosis and treatment of these patients, and should facilitate the future development of clinical trials that could define more precisely predictive markers for histological progression or lack of response, and evaluate new drugs or treatments.

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“…5,35 When treatment is indicated (i.e., occurrence of a large symptomatic splenomegaly and/or cytopenia), splenectomy is the treatment of choice. 31 Splenectomy is beneficial in terms of improvement of performance status and correction of cytopenias 4,31 This benefit, which is due to the disappearance of hypersplenism but also the reduction of mar- Abbreviations: HCV, hepatitis C virus; IFN, interferon; LDH, lactate dehydrogenase; R-CHOP, rituximab, vincristine, doxorubicin, cyclophosphamide, predisolone; R-FC, rituximab, fludarabine, cyclophosphamide row infiltration after splenectomy, 36 persists for years, with an interval before requiring further treatment of over 5 years, even if the patient develops progressive lymphocytosis. 31 Chemotherapy based on alkylating agents (chlorambucil or cyclophosphamide) or purine analogues (fludarabine) has also been reported as an effective treatment in non-randomized studies or in retrospective analyses.…”

Section: Treatmentmentioning

confidence: 99%

Clinical Presentation and Management of Marginal Zone Lymphomas

Thiéblemont¹

2005

Hematology

108

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Marginal-zone lymphoma (MZL) includes three subtypes depending on the site of lymphoma involvement: extranodal marginal zone B-cell lymphoma of mucosaassociated lymphoid tissue (MALT-lymphoma); splenic MZL; and nodal MZL. Beside a common cell-of-origin and similarities concerning a possible chronic antigenic stimulation by microbial pathogens and/or autoantigens, the clinical presentation is very different with symptoms related to lymphoma location. MALT and splenic MZL present with an indolent disease with good performance status, no B symptoms, and no adverse prognostic factors and are associated with long survival. Patients with nodal MZL present with a more aggressive disease and have a shorter failurefree survival. Clinical and biological prognostic factors identified in reported series are heterogeneous. The optimal treatment has yet to be defined for the three subtypes, and current strategies will be described in this review.Marginal zone B-cell lymphomas (MZL) represent a group of lymphomas whose cells originate from B lymphocytes normally present in a distinct anatomical location, the socalled "marginal zone" (MZ) of the secondary lymphoid follicles.1 These cells are anatomically localized in the lymphoid organs (spleen and lymph nodes) and in the nonlymphoid organs (mucosa-associated lymphoid tissue [MALT] or non-mucosal tissue such as skin, orbit and dura). Depending on the site of involvement, the International Lymphoma Study Group individualized three distinct subtypes of MZL: (1) extranodal MZL of MALT type, (2) splenic MZL (with or without villous lymphocytes), and (3) nodal MZL (with or without monocytoid B cells).2,3 Despite this classification, the relative rarity of these lymphomas and difficulties in distinguishing them from other low-grade lymphoma subtypes are obstacles to conducting epidemiological surveys and to describing clinical features and outcomes. Moreover, no prospective studies on large series have been published to date, making therapeutic decisions difficult. Data regarding clinical and biological prognostic markers are limited, and it is therefore difficult to predict those in whom the disease will be more aggressive. This review will present recent data describing the epidemiology, clinical features, staging, and therapy of these lymphomas. EpidemiologyMZL account for between 5% and 17% of all non-Hodgkin lymphomas (NHL) in adults depending on the series. MALT lymphoma is the most frequent of the MZL subtypes, representing 50% to 70% of MZL and 7% to 8% of NHL. The splenic and the nodal MZL represent 20% and 10% of MZL, respectively, and account for less than 1% of NHL. Most of the cases occur in adults, with a median age of approximately 60 years, except for splenic MZL with villous lymphocytes (SLVL), occurring in adults at a median age of around 70 years. [4][5][6][7][8]

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Splenectomy influences bone marrow infiltration in patients with splenic marginal zone cell lymphoma with or without villous lymphocytes

Cited by 56 publications

References 47 publications

Splenic marginal zone lymphoma: a prognostic model for clinical use

Splenic marginal zone lymphoma: a prognostic model for clinical use

Splenic marginal zone lymphoma proposals for a revision of diagnostic, staging and therapeutic criteria

Clinical Presentation and Management of Marginal Zone Lymphomas

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