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

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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.

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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Division of Bone Marrow Transplantation, Department of Internal Medicine 1, Medical University of Vienna, Vienna, Austria

    Stefan Wöhrer

  2. Division of Oncology, Department of Internal Medicine 1, Medical University of Vienna, Waehringerguertel 18-20, 1090, Vienna, Austria

    Barbara Kiesewetter, Julia Fischbach & Markus Raderer

  3. Department of Pathology, Medical University of Vienna, Vienna, Austria

    Leonhard Müllauer

  4. Department of Internal Medicine I, Medical University of Vienna, Vienna, Austria

    Marlene Troch

  5. Department of Ophthalmology, Medical University of Vienna, Vienna, Austria

    Julius Lukas

  6. Department of Radiology, Medical University Vienna, Vienna, Austria

    Marius E. Mayerhoefer

Authors
  1. Stefan Wöhrer
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  2. Barbara Kiesewetter
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  3. Julia Fischbach
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  4. Leonhard Müllauer
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  5. Marlene Troch
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  6. Julius Lukas
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  7. Marius E. Mayerhoefer
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  8. Markus Raderer
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Correspondence to Markus Raderer.

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Wöhrer, S., Kiesewetter, B., Fischbach, J. et al. Retrospective comparison of the effectiveness of various treatment modalities of extragastric MALT lymphoma: a single-center analysis. Ann Hematol 93, 1287–1295 (2014). https://doi.org/10.1007/s00277-014-2042-z

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  • DOI: https://doi.org/10.1007/s00277-014-2042-z

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