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Annals of Hematology

, Volume 93, Issue 8, pp 1287–1295 | Cite as

Retrospective comparison of the effectiveness of various treatment modalities of extragastric MALT lymphoma: a single-center analysis

  • Stefan Wöhrer
  • Barbara Kiesewetter
  • Julia Fischbach
  • Leonhard Müllauer
  • Marlene Troch
  • Julius Lukas
  • Marius E. Mayerhoefer
  • Markus RadererEmail author
Original Article

Abstract

We have performed a retrospective analysis of all patients with extragastric mucosa-associated lymphoid tissue (MALT) lymphoma treated at our institution to compare the efficacy of first-line therapeutic modalities including surgery, radiation, systemic therapy, and antibiotics. One hundred eighty-five patients with extragastric MALT lymphoma with a median age of 63 (interquartile range (IQR) 50–74) years and a median follow-up time of 49 (IQR 18–103) months were retrospectively analyzed. Time to progression and time to next therapy were used as surrogate endpoints for efficacy. Patients having either surgery (100 %), chemo/immunotherapy (85.5 %), or radiation (80 %) had significantly (p = 0.01) higher response rates than patients treated with antibiotics (33.3 %). Patients who were irradiated had significantly more progressive disease, but also the longest follow-up time. Stage, elevated LDH, anemia, elevated beta-2 microglobulin, plasmacytic differentiation, monoclonal gammopathy, or autoimmune disease did not influence the rate of disease progression nor did complete remission or partial remission from initial therapy influence time to and rate of progression. There was no significant difference in the median time to progression (p = 0.141), but the estimated time to progression (p = 0.023) as well as the estimated time to next therapy (p = 0.021) was significantly different among the various cohorts favoring surgery, chemo/immunotherapy, and radiation. Our results suggest extragastric MALT lymphoma as a potential systemic disease irrespective of initial stage. Radiation, surgery, and chemo/immunotherapy seem to be equally effective in achieving remissions and prolonged progression free survivals, but a curative potential is questionable. Localized MALT lymphomas affecting the thyroid gland or the lungs have excellent long-term progression-free survivals with surgical treatment only.

Keywords

MALT lymphoma Antibacterial agents Drug therapy Surgery Radiotherapy 

Notes

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

277_2014_2042_MOESM1_ESM.pdf (145 kb)
Supp. Fig. 1 (PDF 145 kb)
277_2014_2042_MOESM2_ESM.pdf (139 kb)
Supp. Fig. 2 (PDF 139 kb)
277_2014_2042_MOESM3_ESM.pdf (143 kb)
Supp. Fig. 3 (PDF 143 kb)

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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Stefan Wöhrer
    • 1
  • Barbara Kiesewetter
    • 2
  • Julia Fischbach
    • 2
  • Leonhard Müllauer
    • 3
  • Marlene Troch
    • 4
  • Julius Lukas
    • 5
  • Marius E. Mayerhoefer
    • 6
  • Markus Raderer
    • 2
    Email author
  1. 1.Division of Bone Marrow Transplantation, Department of Internal Medicine 1Medical University of ViennaViennaAustria
  2. 2.Division of Oncology, Department of Internal Medicine 1Medical University of ViennaViennaAustria
  3. 3.Department of PathologyMedical University of ViennaViennaAustria
  4. 4.Department of Internal Medicine IMedical University of ViennaViennaAustria
  5. 5.Department of OphthalmologyMedical University of ViennaViennaAustria
  6. 6.Department of RadiologyMedical University ViennaViennaAustria

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