Elsevier, Journal of the Formosan Medical Association, 6(109), p. 463-471, 2010
DOI: 10.1016/s0929-6646(10)60078-2
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Background/Purpose: Gastric mucosa-associated lymphoid tissue lymphoma ( MALToma) usually presents at an early stage involving only the stomach and /or regional lymph nodes. Although a sequential transformation from low- grade gastric MALToma (GM) to high-grade GM to secondary diffuse large B- cell lymphoma (DLBCL) is commonly assumed, documented cases of transformation are rare. We aim to determine the frequency of transformation. Methods: We identified 55 early low-grade GMs, 18 early high-grade GMs, and 13 advanced GMs at the National Taiwan University Hospital from 1995 to 2005. The median follow-up time was 59 months. Results: We found that only one early low-grade GM and two early high- grade GMs transformed into secondary DLBCLs and progressed outside the stomach and regional lymph nodes. Significantly, we identified 13 low- grade GMs that were refractory to Helicobacter eradication therapy or relapsed after initial response. All 13 cases had been followed-up for at least 3 years without development of secondary DLBCLs. The frequency of transformation for early low-grade GM was less than 2% ( 1/55). Although two lymphoma-unrelated mortalities were identified, none of the 55 patients with early-low grade GMs died of the disease. Conclusion: Compared with chronic lymphocytic leukemia, which has a 16% transformation rate and a median transformation time of 24 months, we conclude that early low-grade GM rarely transforms into secondary DLBCL or progresses beyond the stomach. Without transformation or progression, patients with early low-grade GM rarely die of the disease and should be treated conservatively. ; 附設醫院腫瘤醫學部 ; 醫學院附設醫院 ; 期刊論文