Gut Liver.  2018 May;12(3):278-287. 10.5009/gnl17217.

Prevalence and Implications of Bone Marrow Involvement in Patients with Gastric Mucosa-Associated Lymphoid Tissue Lymphoma

Affiliations
  • 1Center for Gastric Cancer, National Cancer Center, Goyang, Korea. crystal522@ncc.re.kr
  • 2Department of Laboratory Medicine, Asan Medical Center, Seoul, Korea.
  • 3Center for Hematologic Malignancy, National Cancer Center, Goyang, Korea.

Abstract

BACKGROUND/AIMS
Mucosa-associated lymphoid tissue (MALT) lymphoma of the stomach is an uncommon disease. Bone marrow involvement is reported even in patients with only a mucosal lesion. We evaluated the prevalence and risk factors of marrow involvement and its implications for diagnosis and treatment.
METHODS
In total, 132 patients who were diagnosed with gastric MALT lymphoma at the National Cancer Center in Korea between January 2001 and December 2016 were enrolled in the study. The patient data were collected and analyzed retrospectively.
RESULTS
Of the 132 patients, 47 (35.6%) were male, with a median age of 52 years (range, 17 to 81 years). The median follow-up duration was 48.8 months (range, 0.5 to 169.9 months). Helicobacter pylori infection was detected in 82 patients (62.1%). Most patients (80.3%) had stage IE1 according to the modified Ann Arbor staging system. Ninety-two patients underwent bone marrow evaluation, and four patients (4.3%) had marrow involvement. Of these patients, one presented with abdominal lymph node involvement, while the other three had stage IE1 disease if marrow involvement was disregarded. All three patients had no significant symptoms and were monitored after local treatment without evidence of disease aggravation.
CONCLUSIONS
Bone marrow involvement was found in 4.3% of the patients with gastric MALT lymphoma. Bone marrow examination may be deferred because marrow involvement does not change the treatment options or outcome in gastric MALT lymphoma confined to the stomach wall.

Keyword

Lymphoma; B-cell, marginal zone; Bone marrow involvement; Helicobacter pylori; Prognosis

MeSH Terms

Bone Marrow Examination
Bone Marrow*
Diagnosis
Follow-Up Studies
Helicobacter pylori
Humans
Korea
Lymph Nodes
Lymphoid Tissue
Lymphoma
Lymphoma, B-Cell, Marginal Zone*
Male
Prevalence*
Prognosis
Retrospective Studies
Risk Factors
Stomach
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