Treatment of Extranodal Marginal Zone B-Cell Lymphoma of Mucosa-Associated Lymphoid Tissue Type With Cladribine: A Phase II Study

Jäger, Gerald; Neumeister, Peter; Brezinschek, Ruth I.; Hinterleitner, Thomas; Fiebiger, Wolfgang; Penz, Melitta; Neumann, Hans‐Günter; Mlineritsch, Brigitte; DeSantis, Maria; Quehenberger, Franz; Chott, Andreas; Beham‐Schmid, Christine; Höfler, Gerald; Linkesch, Werner; Raderer, Markus

doi:10.1200/jco.2002.05.117

Cited by 125 publications

(91 citation statements)

References 25 publications

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“…While this was not a randomized study, the data suggest that the addition of rituximab to cladribine is not particularly beneficial, in terms of remission rates, in patients with MALT lymphoma. Compared to data from an older series, in which the CR rate was 100% in gastric MALT lymphomas and 45% in non-gastric MALT lymphomas, 5 the results in the present series do not appear to be strikingly better and again underscore the difference between gastric and non-gastric MALT lymphomas. However, prospective, randomized trials with long-term follow-up are warranted in order to determine whether the addition of rituximab has an influence on time to next treatment or, ultimately, on survival.…”

Section: © F E R R a T A S T O R T I F O U N D A T I O Ncontrasting

confidence: 86%

“…2,3 Efficacy data for both rituximab and cladribine are available for B-cell neoplasms and some limited data have also been reported for MALT lymphoma. [5][6][7] Cladribine is a potent purine nucleoside analogue with cytotoxic effects on both dividing and non-dividing lymphocytes. It is remarkably effective in hairy cell leukemia, with overall response rates of up to 98%, and is currently considered standard therapy in this disease.…”

Section: Discussionmentioning

confidence: 99%

“…7/19 patients) does not appear to be improved when compared to that in our initial study, in which 45% of patients with non-gastric MALT lymphomas achieved a CR. As already discussed in the literature, 2,5 there are various possible explanations for the apparently superior results in gastric MALT lymphomas including a different biology due to pathogenic mechanisms such as HP infection in gastric MALT lymphomas versus autoimmune diseases in non-gastric MALT lymphomas. In addition, it can be speculated that the routine histological assessment of treatment responses in gastric MALT lymphoma might allow a more exact evaluation than radiological methods, which could lead to underreporting of CR due to remnants of scar tissue in, for example, the lung, orbit or lymph nodes.…”

Section: © F E R R a T A S T O R T I F O U N D A T I O Nmentioning

confidence: 97%

“…In a pivotal trial, high efficacy was seen in a cohort of patients with chemotherapy-naïve gastric MALT lymphoma with an overall response rate of 100%, 5 which was maintained after a median follow-up of 6 years in these patients. While the role of the chimeric anti-CD20 antibody rituximab in combination with chemotherapies is undisputed in almost all types of B-cell lymphomas, its use in MALT lymphoma is being tested in an ongoing randomized trial and it is currently not approved for this indication in Europe.…”

Section: © F E R R a T A S T O R T I F O U N D A T I O Nmentioning

confidence: 99%

“…4 Both the anti-CD20 antibody rituximab and the nucleoside analogue 2-chlorodeoxyadenosine (cladribine, 2CdA) are effective drugs in the treatment of B-cell lymphomas and have been tested in patients with MALT lymphomas. [5][6][7] Although both agents have a favorable toxicity profile, some caveats concerning their use remain, such as suboptimal penetration of rituximab into mucosal structures and the inferior response of non-gastric MALT lymphomas as opposed to gastric disease when using cladribine. As MALT lymphomas show a very indolent clinical course with good response rates to various therapeutic agents, the objective in systemic therapy of MALT Currently, there is no standard systemic treatment for extranodal marginal zone B-cell lymphoma of the mucosaassociated lymphoid tissue.…”

Section: Introductionmentioning

confidence: 99%

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Rituximab plus subcutaneous cladribine in patients with extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue: a phase II study by the Arbeitsgemeinschaft Medikamentose Tumortherapie

et al. 2012

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Section: © F E R R a T A S T O R T I F O U N D A T I O Ncontrasting

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Section: © F E R R a T A S T O R T I F O U N D A T I O Nmentioning

confidence: 97%

Section: © F E R R a T A S T O R T I F O U N D A T I O Nmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Rituximab plus subcutaneous cladribine in patients with extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue: a phase II study by the Arbeitsgemeinschaft Medikamentose Tumortherapie

et al. 2012

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Cutaneous B‐cell lymphoma: Pathological spectrum and clinical outcome in 51 consecutive patients

Sah¹,

Barrans²,

Parapia³

et al. 2004

American J Hematol

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The clinical behavior and optimal treatment of patients presenting with skin infiltration by B-cell lymphoma have not been established. To clarify this we assessed the clinical and laboratory features of 51 patients presenting with cutaneous infiltration by B-cell lymphoma. Follow-up data was available for 46 patients with a median age of 68 years (range 16-89 years) and a median follow-up of 32.5 months (range 5-123 months). Thirty-three of 51 (65%) patients had diffuse large B-cell lymphoma (DLBCL), and 15/51 (29%) had marginal zone lymphoma (MZL). The remaining 3 patients had follicular lymphoma, CLL, and post-transplant lymphoproliferative disease. Of the 33 patients with DLBCL, follow-up was available in 29; 24/29 (83%) had primary cutaneous disease, which was unifocal in 17/24 (71%). Following treatment, 8/24 (33%) of the primary cases relapsed. Of the 8 who relapsed, 7 had received local forms of treatment only. Follow-up data was available in 14/15 patients with MZL. 11/14 (79%) had primary cutaneous disease, which was unifocal in 8 (73%). Following treatment, 4 of these cases relapsed (36%); all had received local therapy only. It is evident from this study that a significant proportion (~20%) of patients who present with cutaneous infiltration by B-cell lymphoma have systemic disease. Staging is therefore mandatory in these patients. Approximately 1/3 patients with primary cutaneous DLBCL or MZL ultimately relapse, and relapse rates appear higher in thosepatients receiving local therapy only. Systemic or combined modality therapy may therefore be the most appropriate treatment at presentation. This should be assessed prospectively in randomized trials. Am.

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Nongastric marginal zone B‐cell lymphoma: Analysis of 247 cases

Ryoo

Kim

et al. 2007

American J Hematol

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Nongastric marginal zone B-cell lymphoma (NG-MZL) is a relatively uncommon indolent lymphoma. From 1990 to 2005, a total of 247 patients with histologically confirmed NG-MZL were analyzed. Ann Arbor stage I/II disease was present in 78% (167 out of 215). One hundred eighty-six patients out of two hundred eight were categorized into the low/low-intermediate risk group (89%) according to International Prognostic Index (IPI). Eighty percent (172/ 215) were in low risk group according to Follicular Lymphoma International Prognostic Index (FLIPI). Complete and partial remissions (CR and PR) were achieved in 140 (92.7%) and 8 (5.3%) of the 151 stage I/II patients. Especially, radiation containing treatment achieved 96% CR rate (108 out of 113). In 38 patients with stage III/IV, CR and PR were achieved in 17 (44.7%) and 11 (26.3%), respectively. The estimated five-year overall survival (OS) and progression-free survival (PFS) were 93.8% and 70.1%, respectively. Although anthracyclinecontaining regimen could achieve higher CR rate, it did not improve PFS. Stage III/IV, low hemoglobin, poor performance status, high/high-intermediate IPI, poor risk FLIPI, and nodal MZL were poor prognostic factors for PFS. NG-MZL is an indolent disease. FLIPI has strong power to predict the prognosis of NG-MZL. Am. J. Hematol. 82:446-452, 2007.Wiley-Liss, Inc.

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Treatment of Extranodal Marginal Zone B-Cell Lymphoma of Mucosa-Associated Lymphoid Tissue Type With Cladribine: A Phase II Study

Abstract: Our data demonstrate that 2-CdA is highly effective in inducing CR in 84% of patients with MALT-type lymphoma.

Cited by 125 publications

References 25 publications

Rituximab plus subcutaneous cladribine in patients with extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue: a phase II study by the Arbeitsgemeinschaft Medikamentose Tumortherapie

Rituximab plus subcutaneous cladribine in patients with extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue: a phase II study by the Arbeitsgemeinschaft Medikamentose Tumortherapie

Cutaneous B‐cell lymphoma: Pathological spectrum and clinical outcome in 51 consecutive patients

Nongastric marginal zone B‐cell lymphoma: Analysis of 247 cases

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