Molecular follow-up in gastric mucosa-associated lymphoid tissue lymphomas: early analysis of the LY03 cooperative trial.

Abstract

Gastric marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT)-type can regress after anti-Helicobacter pylori treatment. The International Extranodal Lymphoma Study Group, the United Kingdom Lymphoma Group, and the Groupe d'Etude des Lymphomes de l'Adulte have conducted a trial to ascertain whether the addition of chlorambucil is of benefit after anti-H pylori therapy. At the last interim analysis, 105 (55%) of 189 patients had achieved a complete histologic remission after anti-Helicobacter therapy. To further assess the ability of treatment to eradicate the lymphoma clone, we analyzed the gastric biopsies from a subset of the patients by polymerase chain reaction (PCR) targeted to the immunoglobulin heavy chain genes as a molecular marker for minimal residual disease. Sixty-two cases were examined at diagnosis. Fifty-four cases were monoclonal by PCR. Forty-two of these patients achieved histologic complete remission (hCR) after anti-Helicobacter treatment: 34 cases underwent molecular follow-up analysis. Fifteen patients (44%) were in molecular remission with a median follow-up of 2 years after antibiotic treatment and of 1 year after the achievement of hCR. Less than half of the patients with MALT lymphoma can achieve sustained molecular remission after anti-Helicobacter therapy. The presence of molecular disease in the absence of histologic disease does not appear to be associated with histologic relapse, but, given the indolent nature of MALT lymphomas, a longer follow-up is needed.

• Authors: Francesco Bertoni, Annarita Conconi, Carlo Capella, Teresio Motta, Roberto Giardini, Maurilio Ponzoni, Ennio Pedrinis, Domenico Novero, Paolo Rinaldi, Giovanni Cazzaniga, Andrea Biondi, Andrew Wotherspoon, Barry William Hancock, Paul Smith, Robert Souhami, Finbarr E Cotter, Franco Cavalli, Emanuele Zucca, International Extranodal Lymphoma Study Group, United Kingdom Lymphoma Group
• Journal: Blood (Blood) Vol. 99 Issue 7 Pg. 2541-4 (Apr 01 2002) ISSN: 0006-4971 [Print] United States
• PMID: 11895791 (Publication Type: Clinical Trial, Controlled Clinical Trial, Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)

Chemical References

• Antineoplastic Agents, Alkylating
• Immunoglobulin Heavy Chains
• Chlorambucil

Topics

• Antineoplastic Agents, Alkylating (therapeutic use)
• Chlorambucil (therapeutic use)
• Disease-Free Survival
• False Negative Reactions
• Follow-Up Studies
• Helicobacter Infections (drug therapy)
• Helicobacter pylori
• Humans
• Immunoglobulin Heavy Chains (genetics)
• Lymphoma, B-Cell, Marginal Zone (drug therapy, genetics, immunology)
• Neoplasm, Residual (diagnosis)
• Polymerase Chain Reaction
• Reproducibility of Results
• Time Factors