[Show abstract][Hide abstract] ABSTRACT: Mucosa-associated lymphoid tissue lymphoma is a histological type of marginal zone non-Hodgkin's lymphoma (NHL). Its clinical features and prognosis have seldom been reported because of its indolent clinical course. This study was to explore the clinical features and prognosis of this disease.
Clinical data of 90 pathologically confirmed mucosa-associated lymphoid tissue lymphoma patients, treated from December 1997 to February 2007, were analyzed.
Of the 90 patients, 23 (25.6%) had gastric lymphoma and 67 (74.4%) had non-gastric lymphoma, with a median age of 52 (range, 13-77); 75 (83.3%) had stage I-II disease and 15 (16.7%) had stage III-IV disease; 31 (34.4%) had multiple organ involvement and 40 (44.4%) had nodal involvement. The percentage of nodal involvement was significantly higher in non-gastric group than in gastric group (P=0.040). The complete remission (CR) rate after treatment was 72.1%. The patients were followed up for a median of 31.4 months. The 5-year overall survival rates of patients with and without nodal involvement were 58.7% and 88.4%, respectively (P=0.012). The median time to progression was significantly longer in patients with IPI score of 0-2 than in those with IPI score of > 2 (61.9 months vs. 5.2 months, P=0.005), and was significantly longer in patients who got CR after initial treatment than in those without CR (not reached vs. 15.0 months, P=0.030). In non-gastric lymphoma group, IPI score was an independent prognostic variable of overall survival (P=0.023).
Mucosa-associated lymphoid tissue lymphoma should be considered as a kind of disseminated indolent lymphoma. The patients with non-gastric lymphoma are likely to have nodal involvement. Patients with poor prognostic factors should be treated more aggressively.
Ai zheng = Aizheng = Chinese journal of cancer 08/2009; 28(7):734-9. DOI:10.5732/cjc.008.10818
[Show abstract][Hide abstract] ABSTRACT: Hodgkin and Reed-Sternberg (HRS) cells of classical Hodgkin's Lymphoma (CHL) express B-cell marker CD20 with a reported frequency of 5%-58%. The prognostic significance of CD20 expression in HRS cells of CHL is still controversial. This study was to investigate the prognostic significance of CD20 expression in naive CHL patients.
The expression of CD20, CD15 and CD30 in 70 specimens of CHL were detected by immunohistochemistry; tumor morphology was observed with HE staining. A sample with CD20 expression on more than 10% of HRS cells was considered CD20-positive. The failure-free survival (FFS) and overall survival (OS) rates were compared by log-rank test. Cox proportional hazard model was used in multivariate analysis.
Of the 70 cases of CHL, 21 (30.0%) were CD20-positive, 26 (37.1%) were CD15-positive, and all were CD30-positive. The positive rate of CD20 was significantly higher in the patients aged > or =45 years than in those aged <45 years (53.3% vs. 23.6%, P=0.026). The patients were followed up for a median of 58.3 months. The 5-year FFS rates were 76.2% in CD20-positive patients and 77.6% in CD20-negative patients (P=0.484). The 5-year OS rates were 80.4% in CD20-positive patients and 92.5% in CD20-negative patients (P=0.006). Cox multivariate analysis showed that age and stage were independent prognostic factors for FFS and OS.
The positive rate of CD20 is relatively low in HRS cells of CHL. It is higher in the patients aged > or =45 years than in those aged <45 years. However, according to our results, the expression of CD20 is not an independent prognostic factor for FFS and OS of naive CHL patients.
Ai zheng = Aizheng = Chinese journal of cancer 11/2008; 27(11):1197-203.
[Show abstract][Hide abstract] ABSTRACT: Currently, 60% patients with advanced Hodgkin's lymphoma could be cured by receiving standard treatments. The international prognostic factor project on advanced Hodgkin's lymphoma has developed a concept of international prognostic score (IPS) based on seven adverse prognostic factors consisting of male sex, age 45 years or older, stage IV disease, leukocytosis, lymphocytopenia, low hemoglobin and low serum albumin for newly diagnosed advanced Hodgkin's lymphoma patients. This study was to explore the feasibility of the international prognostic score in advanced Hodgkin's lymphoma.
We performed a retrospective review of 141 patients with untreated advanced Hodgkin's lymphoma in Cancer Center of Sun Yat-sen University between January 1980 and December 2004. IPS was defined as the number of adverse prognostic factors presented at diagnosis. The rates of failure free survival (FFS) and overall survival (OS) were estimated using the method of Kaplan-Meier and compared according to IPS by log-rank test. Cox proportional hazard model was used in multivariate analysis.
The 5-year FFS and OS for 141 advanced Hodgkin's lymphoma patients were 57.6%, 68.1% respectively. Estimated 5-year FFS was 67.7%, 63.2%, 61.8%, 34.9% for patients with 0-1, 2, 3, > or =4 of the adverse prognostic factors respectively. Estimated 5-year OS was 81.0%, 75.5%, 70.3%, 42.3% for patients with 0-1, 2, 3, > or =4 of the adverse prognostic factors respectively. The 5-year FFS for low risk patients with IPS=0-2 and high risk patients with IPS> or =3 were 65.4%, 48.9% respectively (log-rank test: P=0.012); the 5 year OS for patients with IPS=0-2 and IPS> or =3 were 78.4%, 57.1% respectively (log-rank test: P=0.004). Low risk patients with IPS=0-2 had superior overall survival than high risk patients with IPS> or =3 when treated with ABVD or MOPP. The FFS and OS of the advanced HL patients at high risk treated with ABVD were better than those treated with MOPP. Multivariate analysis demonstrated that B symptoms, extranodal disease and MOPP chemotherapy were independent adverse prognostic factors for FFS and OS.
The IPS shows good prognostic power in advanced HL. High risk advanced HL patients treated with MOPP have inferior survival than those treated with ABVD, thus we recommend patients to be treated with ABVD or more intensive regimen.
Ai zheng = Aizheng = Chinese journal of cancer 08/2006; 25(8):1013-8.