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

• Published in: Gut and liver 2018, 12(3), , pp.278-287
• Main Authors: Choi, Sang Il, Kook, Myeong-Cherl, Hwang, Sanghyun, Kim, Young-Il, Lee, Jong Yeul, Kim, Chan Gyoo, Choi, Il Ju, Lee, Hyewon, Eom, Hyeon Seok, Cho, Soo-Jeong
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents - administration & dosage; b-cell; Biopsy, Needle; Bone Marrow - pathology; bone marrow involvement; Bone Marrow Neoplasms - drug therapy; Bone Marrow Neoplasms - pathology; Drug Therapy, Combination; Endoscopy - methods; Female; Gastric Mucosa; Helicobacter Infections - drug therapy; Helicobacter Infections - pathology; helicobacter pylori; Humans; lymphoma; Lymphoma, B-Cell, Marginal Zone - drug therapy; Lymphoma, B-Cell, Marginal Zone - pathology; Male; marginal zone; Middle Aged; Neoplasm Invasiveness; Original; prognosis; Proton Pump Inhibitors - administration & dosage; Retrospective Studies; Stomach Neoplasms - drug therapy; Stomach Neoplasms - pathology; Treatment Outcome; Young Adult; 내과학
• ISSN: 1976-2283; 2005-1212
• DOI: 10.5009/gnl17217

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. 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. 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). 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. 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.