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Plasmacytic differentiation in MALT lymphomas following treatment with rituximab

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Abstract

Mucosa-associated lymphoid tissue (MALT) lymphomas are B cell neoplasms which commonly affect the gastrointestinal (GI) tract. Gastrointestinal MALT lymphomas rarely show plasmacytic differentiation (PCD), and limited data on the potential influence of the anti-CD20 antibody rituximab (R) on PCD exist in the current literature. We have retrospectively analyzed patients with GI MALT lymphomas treated with R-containing regimens because restaging is routinely performed by repeated biopsies with pathohistological response assessment. Twenty-one patients with GI MALT lymphoma were identified to have undergone R-containing therapy. In 19 patients, the lymphoma originated in the stomach, while the colon was the primarily affected organ in two cases. Four patients received R monotherapy and 17 combinations of R with various chemotherapeutic agents. Only two patients with gastric MALT lymphoma had PCD before initiation of therapy. In 7 of 19 patients (37%) without PCD at diagnosis, restaging revealed PCD after or while on treatment with R-containing regimens. Out of these seven patients, only one patient had a complete response as opposed to 10/12 without PCD. These data suggest that R or R-containing treatment regimens may not optimally eradicate the plasma cell component and thus lead to PCD in patients with GI MALT lymphoma. In view of this, rebiopsy and histological re-assessment appear mandatory in patients failing/relapsing after R-containing regimens.

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Authors and Affiliations

  1. Division of Oncology, Department of Internal Medicine I, Comprehensive Cancer Center of the Medical University Vienna—General Hospital, Waehringer Guertel 18-20, 1090, Vienna, Austria

    Marlene Troch, Barbara Kiesewetter & Markus Raderer

  2. Division of Gastroenterology, Department of Internal Medicine III, Comprehensive Cancer Center of the Medical University Vienna—General Hospital, Vienna, Austria

    Werner Dolak & Andreas Püspök

  3. Division of Haematology and Hemostaseology, Department of Internal Medicine I, Comprehensive Cancer Center of the Medical University Vienna—General Hospital, Vienna, Austria

    Ulrich Jaeger

  4. Division of Pathology, Department of Internal Medicine III, Comprehensive Cancer Center of the Medical University Vienna—General Hospital, Vienna, Austria

    Leonhard Müllauer & Andreas Chott

  5. Department of Pathology, Wilheminenspital, Vienna, Austria

    Andreas Chott

Authors
  1. Marlene Troch
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  2. Barbara Kiesewetter
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  3. Werner Dolak
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  4. Ulrich Jaeger
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  5. Andreas Püspök
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  6. Leonhard Müllauer
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  7. Andreas Chott
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  8. Markus Raderer
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Correspondence to Markus Raderer.

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Troch, M., Kiesewetter, B., Dolak, W. et al. Plasmacytic differentiation in MALT lymphomas following treatment with rituximab. Ann Hematol 91, 723–728 (2012). https://doi.org/10.1007/s00277-011-1387-9

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  • DOI: https://doi.org/10.1007/s00277-011-1387-9

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