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Panda G, Kalra B, Rishi A, Khanna N, Kakoti S, Sridhar E, Shet T, Sengar M, Nayak L, Bagal B, Jain H, Laskar SS, Goda JS. Long-Term Clinical Outcomes and Sequelae of Therapy in Early-Stage Orbital Mucosa-Associated Lymphoid Tissue Lymphoma. CLINICAL LYMPHOMA, MYELOMA & LEUKEMIA 2022; 22:513-522. [PMID: 35027338 DOI: 10.1016/j.clml.2021.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 11/26/2021] [Accepted: 12/18/2021] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Orbital mucosa-associated lymphoid tissue (MALT) lymphoma, which are rare and indolent, often present at an early stage. We report the efficacy and safety outcomes of treatment in these patients. METHODS We analyzed adult patients with stage IE or IIE orbital MALT lymphoma between 1999 and 2017 treated at our institute. We assessed local control (LC) rates, overall survival (OS), relapse-free survival (RFS) using Kaplan Meier method and the incidence of late toxicities. RESULTS Seventy patients were analyzed for clinical outcomes. The median age at diagnosis was 52 years (IQR-45-62 years). Radiotherapy was offered to 97% of patients and the dose ranged from 36 to 45 Gy. Chemotherapy was administered in 5(7.1%) patients. Relapse occurred in 8 patients (local: 2, distant: 6). At a median follow-up of 101 months (IQR-47-146 months), the median OS and RFS was not reached. 8-year OS, RFS and LC rates were 96.5%, 88.5%, 96.7% respectively. Univariate analysis showed age ≤60 years and lacrimal involvement significantly correlated with better OS (P = .01 and .04, respectively). Cataract was the most common sequelae observed in 31 patients (44.3%). CONCLUSION Moderate doses of radiotherapy are curative in early-stage orbital MALT lymphoma with favorable clinical outcomes. Lower doses of radiation can reduce the toxicity further, without compromising efficacy.
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Affiliation(s)
- Goutam Panda
- Adult Haematolymphoid Disease Management Group, Tata Memorial Centre & HomiBhaba National Institute, Mumbai, Maharashtra, India
| | - Babusha Kalra
- Adult Haematolymphoid Disease Management Group, Tata Memorial Centre & HomiBhaba National Institute, Mumbai, Maharashtra, India
| | - Anupam Rishi
- Adult Haematolymphoid Disease Management Group, Tata Memorial Centre & HomiBhaba National Institute, Mumbai, Maharashtra, India
| | - Nehal Khanna
- Adult Haematolymphoid Disease Management Group, Tata Memorial Centre & HomiBhaba National Institute, Mumbai, Maharashtra, India
| | - Sangeeta Kakoti
- Adult Haematolymphoid Disease Management Group, Tata Memorial Centre & HomiBhaba National Institute, Mumbai, Maharashtra, India
| | - Epari Sridhar
- Adult Haematolymphoid Disease Management Group, Tata Memorial Centre & HomiBhaba National Institute, Mumbai, Maharashtra, India
| | - Tanuja Shet
- Adult Haematolymphoid Disease Management Group, Tata Memorial Centre & HomiBhaba National Institute, Mumbai, Maharashtra, India
| | - Manju Sengar
- Adult Haematolymphoid Disease Management Group, Tata Memorial Centre & HomiBhaba National Institute, Mumbai, Maharashtra, India
| | - Lingaraj Nayak
- Adult Haematolymphoid Disease Management Group, Tata Memorial Centre & HomiBhaba National Institute, Mumbai, Maharashtra, India
| | - Bahusaheb Bagal
- Adult Haematolymphoid Disease Management Group, Tata Memorial Centre & HomiBhaba National Institute, Mumbai, Maharashtra, India
| | - Hasmukh Jain
- Adult Haematolymphoid Disease Management Group, Tata Memorial Centre & HomiBhaba National Institute, Mumbai, Maharashtra, India
| | - Siddartha S Laskar
- Adult Haematolymphoid Disease Management Group, Tata Memorial Centre & HomiBhaba National Institute, Mumbai, Maharashtra, India
| | - Jayant S Goda
- Adult Haematolymphoid Disease Management Group, Tata Memorial Centre & HomiBhaba National Institute, Mumbai, Maharashtra, India.
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Marques MDO, Manso PG, Araujo RLC, Brito FDN, Herculani JEDCC, Lemos GGD, Rodrigues MA, Teixeira LF, Espirito Santo KSD, Menezes YD, Cecyn KZ, Colleoni GWB, Baiocchi OCG. Long-term outcomes of ocular adnexal lymphomas: case series from two lymphoma centers in Brazil. Leuk Lymphoma 2021; 62:1013-1015. [PMID: 33461351 DOI: 10.1080/10428194.2020.1855348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
| | - Paulo Goes Manso
- Ophthalmology Department, Universidade Federal de São Paulo, São Paulo, Brasil
| | - Raphael L C Araujo
- Clinical and Experimental Oncology Department, Universidade Federal de São Paulo, São Paulo, Brasil
| | | | | | | | | | | | | | - Yara de Menezes
- Pathology Department, Hospital Alemão Oswaldo Cruz, São Paulo, Brasil
| | - Karin Zattar Cecyn
- Clinical and Experimental Oncology Department, Universidade Federal de São Paulo, São Paulo, Brasil
| | - Gisele W Braga Colleoni
- Clinical and Experimental Oncology Department, Universidade Federal de São Paulo, São Paulo, Brasil
| | - Otavio C G Baiocchi
- Clinical and Experimental Oncology Department, Universidade Federal de São Paulo, São Paulo, Brasil.,Hematology Department, Hospital Alemão Oswaldo Cruz, São Paulo, Brasil
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Çetingül N, Palamar M, Hacıkara Ş, Kamer S, Hekimci Özdemir H, Ataseven E, Barut Selver Ö, Hekimgil M. Extranodal Ocular Adnexal Marginal Zone Lymphoma in a Ten-Year-Old Child. Turk J Ophthalmol 2020; 50:53-55. [PMID: 32167265 PMCID: PMC7086099 DOI: 10.4274/tjo.galenos.2019.62592] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
A 10-year-old girl was brought to the clinic with the complaint of a salmon-colored conjunctival lesion for 1 month. With the aid of histopathological evaluation and other tests, extranodal ocular adnexal marginal zone lymphoma was diagnosed. The patient was graded as T1bN0M0 according to AJCC and Stage 1 according to Ann Arbor classification. She was treated with external radiotherapy at 1.8 Gy/day for 17 days for a total dose of 36 Gy. She is in remission for 26 months and still being followed up.
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Affiliation(s)
- Nazan Çetingül
- Ege University Faculty of Medicine, Department of Child Diseases, İzmir, Turkey
| | - Melis Palamar
- Ege University Faculty of Medicine, Department of Ophthalmology, İzmir, Turkey
| | - Şükriye Hacıkara
- Ege University Faculty of Medicine, Department of Child Diseases, İzmir, Turkey
| | - Serra Kamer
- Ege University Faculty of Medicine, Department of Radiation Oncology, İzmir, Turkey
| | | | - Eda Ataseven
- Ege University Faculty of Medicine, Department of Child Diseases, İzmir, Turkey
| | - Özlem Barut Selver
- Ege University Faculty of Medicine, Department of Ophthalmology, İzmir, Turkey
| | - Mine Hekimgil
- Ege University Faculty of Medicine, Department of Patalogy, İzmir, Turkey
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Abstract
Orbital lymphomas constitute 50-60% of ocular adnexal lymphomas. A total of 2211 cases of orbital lymphoma with a known subtype have been reported in the last 24 years (1994-2017). The vast majority of orbital lymphomas are of B-cell origin (97%), of which extranodal marginal zone B-cell lymphoma (EMZL) (59%) is the most common subtype, followed by diffuse large B-cell lymphoma (23%), follicular lymphoma (9%), and mantle cell lymphoma (5%). Orbital lymphoma is primarily a disease of the elderly. Gender distribution varies according to lymphoma subtype. However, extranodal marginal zone B-cell lymphoma (53%) and follicular lymphoma (75%) show a female predominance, whereas diffuse large B-cell lymphoma shows an even gender distribution. Mantle cell lymphoma has a striking male predominance of 80%. The histopathological subtype and the clinical stage of the disease are the best indicators of prognosis and patient outcome. Low-grade lymphomas such as extranodal marginal zone B-cell lymphoma and FL have a good prognosis, whereas high-grade lymphomas (diffuse large B-cell lymphoma and mantle cell lymphoma) are associated with a poor prognosis. When managing solitary low-grade lymphomas, radiotherapy is the treatment of choice. Chemotherapy, with or without radiotherapy, should be chosen for disseminated and high-grade lymphomas.
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Affiliation(s)
- Tine Gadegaard Olsen
- Department of Pathology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Steffen Heegaard
- Department of Pathology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; Department of Ophthalmology, Rigshospitalet-Glostrup, University of Copenhagen, Copenhagen, Denmark.
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