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Liao Q, Yu Q, Yu C, Zhang M, Xiao E. Pulmonary mucosa-associated lymphoid tissue lymphoma: insights from a 15-year study at a single institution involving 14 clinical cases. World J Surg Oncol 2024; 22:219. [PMID: 39182101 PMCID: PMC11344348 DOI: 10.1186/s12957-024-03500-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 08/13/2024] [Indexed: 08/27/2024] Open
Abstract
OBJECTIVE This study aims to delineate the clinical presentations, imaging features, pathological characteristics, therapeutic strategies, and outcomes of pulmonary mucosa-associated lymphoid tissue (MALT) lymphoma, thereby deducing the most efficacious treatment paradigm. METHODS We conducted a retrospective review of 14 patients diagnosed with pulmonary MALT lymphoma at the Second Xiangya Hospital, affiliated with Central South University, between September 2007 and September 2022, focusing on their clinical profiles, diagnostic pathways, treatment modalities, and prognostic outcomes. RESULTS The cohort's median age was 60 years (ranging from 44 to 81 years), with 64.29% being female and only 14.29% having a history of smoking. The incidence of immunodeficiency diseases among the patients was notably low. Imaging typically revealed pulmonary nodules and masses, with air bronchogram signs evident in 9 patients and pleural effusion in 2. CD20 expression was markedly positive across the board in all patients with pulmonary MALT lymphoma. Among the 12 patients who received intervention, 6 were treated with chemotherapy alone, 2 underwent surgical resection, and 4 benefitted from a combined approach of chemotherapy and surgery. Over the monitoring period, 2 patients succumbed to their disease. The estimated 5- and 10-year overall survival (OS) rates were 91.67% and 76.39%, respectively, with the median progression-free survival (PFS) reaching 7 years. Comparative analysis revealed no significant disparity in PFS between patients treated exclusively with chemotherapy and those receiving both chemotherapy and surgical intervention (P = 0.22). CONCLUSION Pulmonary MALT lymphoma typically exhibits a slow course, with gradual progression and a predominantly positive prognosis. Chemotherapy emerges as the preferred therapeutic option for managing this malignancy.
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Affiliation(s)
- Qiuling Liao
- Department of Radiology, The Second Xiangya Hospital of Central South University, No. 139, Renmin Middle Road, Changsha City, 410011, Hunan Province, China
| | - Qilin Yu
- Department of Radiology, The Second Xiangya Hospital of Central South University, No. 139, Renmin Middle Road, Changsha City, 410011, Hunan Province, China
| | - Cheng Yu
- Department of Radiology, The Second Xiangya Hospital of Central South University, No. 139, Renmin Middle Road, Changsha City, 410011, Hunan Province, China
| | - Minping Zhang
- Department of Radiology, The Second Xiangya Hospital of Central South University, No. 139, Renmin Middle Road, Changsha City, 410011, Hunan Province, China
| | - Enhua Xiao
- Department of Radiology, The Second Xiangya Hospital of Central South University, No. 139, Renmin Middle Road, Changsha City, 410011, Hunan Province, China.
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Freret ME, Tringale KR, Boe L, Imber BS, Joffe E, Yahalom J, Hajj C. Very low-dose radiotherapy for extranodal marginal zone lymphoma of bronchus-associated lymphoid tissue. Leuk Lymphoma 2023; 64:2195-2201. [PMID: 37706509 PMCID: PMC10962616 DOI: 10.1080/10428194.2023.2255706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 08/30/2023] [Accepted: 08/31/2023] [Indexed: 09/15/2023]
Abstract
Extranodal marginal zone lymphoma of bronchus-associated lymphoid tissue (BALT) is a rare cancer for which optimal treatment strategies are undefined. Retrospective analyses suggest excellent outcomes with surgical resection for localized BALT lymphoma; however, the role of radiotherapy remains underexplored. We report the largest-to-date single-center analysis of 13 primary BALT lymphoma patients treated with radiotherapy. Of 15 treated lesions, we report a 100% response rate with complete response (CR) achieved in 67% of lesions. Among 10 lesions treated with very low-dose radiotherapy (VLDRT; 4 Gray [Gy]), 6 (60%) achieved a CR; among 5 lesions treated with full-dose radiotherapy (24-36 Gy), 4 (80%) achieved a CR. There were no local recurrences. Only one patient, treated with 30 Gy, developed an acute grade 3/4 toxic effect. There were no events of radiation-induced secondary malignancies. Our institutional experience indicates that radiotherapy, including VLDRT, is a safe and effective treatment for primary BALT lymphoma.
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Affiliation(s)
- Morgan E. Freret
- Radiation Oncology, Memorial Sloan Kettering Cancer Center (MSKCC), New York, NY, USA
| | - Kathryn R. Tringale
- Radiation Oncology, Memorial Sloan Kettering Cancer Center (MSKCC), New York, NY, USA
| | - Lillian Boe
- Epidemiology and Biostatistics, MSKCC, New York, NY, USA
| | - Brandon S. Imber
- Radiation Oncology, Memorial Sloan Kettering Cancer Center (MSKCC), New York, NY, USA
| | - Erel Joffe
- Lymphoma Service, MSKCC, New York, NY, USA
| | - Joachim Yahalom
- Radiation Oncology, Memorial Sloan Kettering Cancer Center (MSKCC), New York, NY, USA
| | - Carla Hajj
- Radiation Oncology, Memorial Sloan Kettering Cancer Center (MSKCC), New York, NY, USA
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Husnain M, Kuker R, Reis IM, Iyer SG, Zhao W, Chapman JR, Vega F, Lossos IS, Alderuccio JP. Clinical and radiological characteristics of patients with pulmonary marginal zone lymphoma: A single center analysis. Cancer Med 2020; 9:5051-5064. [PMID: 32452658 PMCID: PMC7367627 DOI: 10.1002/cam4.3096] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 04/13/2020] [Accepted: 04/13/2020] [Indexed: 12/18/2022] Open
Abstract
Pulmonary marginal zone lymphoma (PMZL) is the most common non‐Hodgkin lymphoma affecting the lung. PMZL is usually an indolent disease. Clinical and radiological variables associated with shorter survival are largely unknown and no consensus exists on preferred treatment strategy in PMZL. Herein we aimed to identify clinical and radiological features associated with shorter survival and inferior treatment outcomes. Forty patients with PMZL were analyzed. FDG‐avid disease was evident in most patients (93%) with staging PET/CT (n = 15). With a median follow‐up in treated patients (n = 38) of 8.4 years (range 0.07‐18.44), the median progression‐free survival (PFS) and overall survival (OS) were 7.5 years (95% CI 1.8‐9.5) and 15.7 years (95% CI 9.3‐NE) respectively. Shorter PFS was observed in patients who presented at diagnosis with elevated LDH, B symptoms, advanced stage and failed to achieve complete response (CR) after initial treatment. Patients with multifocal lung disease, extrapulmonary MZL and cavitary lesions on CT scans exhibited shorter PFS. Nevertheless, no clinical or radiologic findings were associated with shorter OS. All patients treated with surgery (n = 4) and radiation therapy (n = 3) achieved and remained in CR. No higher grade transformations occurred during the follow‐up period. PMZL exhibited excellent outcomes with a 15‐year PMZL‐related OS of 94.9% (95% CI: 81.25%‐98.7%). Radiation therapy and surgery are potentially curative strategies in localized PMZL.
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Affiliation(s)
- Muhammad Husnain
- Division of Hematology, Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Russ Kuker
- Division of Nuclear Medicine, Department of Radiology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Isildinha M Reis
- Department of Public Health Science, University of Miami Miller School of Medicine, Miami, FL, USA.,Biostatistics and Bioinformatics Core Resource, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Sunil Girish Iyer
- Division of Internal Medicine, Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Wei Zhao
- Biostatistics and Bioinformatics Core Resource, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Jennifer R Chapman
- Division of Hematopathology, Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Francisco Vega
- Division of Hematopathology, Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Izidore S Lossos
- Division of Hematology, Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA.,Department of Molecular and Cellular Pharmacology, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Juan Pablo Alderuccio
- Division of Hematology, Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
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Low SK, Zayan AH, Istanbuly O, Nguyen Tran MD, Ebied A, Mohamed Tawfik G, Huy NT. Prognostic factors and nomogram for survival prediction in patients with primary pulmonary lymphoma: a SEER population-based study. Leuk Lymphoma 2019; 60:3406-3416. [PMID: 31322026 DOI: 10.1080/10428194.2019.1633636] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Primary pulmonary lymphomas (PPLs) are rare lymphoproliferative malignancies arising from the lungs. The prognostic factors and optimal management of PPL have not been clearly defined due to its rarity. This study sought to characterize the significant prognostic factors and develop a validated nomogram for individualized prediction of survival outcomes in patients with PPL. A total of 2325 patients diagnosed with PPL between 1983 and 2010 were identified using the Surveillance, Epidemiology, and End Results (SEER) database. Older age at diagnosis, males, Hispanic race, non-marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue histology, Ann Arbor stage IV were significantly associated with worse OS on multivariable analysis. All treatment modalities, including chemotherapy, surgery, and radiotherapy were independent predictors of survival on univariable analysis. The nomogram built demonstrated good discriminative ability and calibration, with the C-index of 0.690 and 0.730 in the training and validation cohorts, respectively.
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Affiliation(s)
- Soon Khai Low
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Selangor, Malaysia
| | | | - Obaida Istanbuly
- Faculty of Medicine, University of Aleppo, Aleppo, Syrian Arab Republic
| | - Minh Duc Nguyen Tran
- Faculty of Medicine, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam
| | - Amr Ebied
- Egyptian National Blood Transfusion Services, Cairo, Egypt
| | | | - Nguyen Tien Huy
- Evidence Based Medicine Research Group, Ton Duc Thang University, Ho Chi Minh City, Vietnam.,Faculty of Applied Sciences, Ton Duc Thang University, Ho Chi Minh City, Vietnam
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