Published in

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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Early Low-Grade Gastric Maltoma Rarely Transforms into Diffuse Large Cell Lymphoma or Progresses Beyond the Stomach and Regional Lymph Nodes

This paper is made freely available by the publisher.
This paper is made freely available by the publisher.

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Abstract

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