Clinicopathological features of histological transformation from extranodal marginal zone B‐cell lymphoma of mucosa‐associated lymphoid tissue to diffuse large B‐cell lymphoma: an analysis of 467 patients. (27th July 2016)

• Record Type: Journal Article
• Authors: Maeshima, Akiko Miyagi; Taniguchi, Hirokazu; Toyoda, Kosuke; Yamauchi, Nobuhiko; Makita, Shinichi; Fukuhara, Suguru; Munakata, Wataru; Maruyama, Dai; Kobayashi, Yukio; Tobinai, Kensei
• Is Part Of: British journal of haematology. Volume 174:Number 6(2016)
• Page Start: 923
• Page End: 931
• Publication Date: 2016-07-27
• Subjects: mucosa‐associated lymphoid tissue lymphoma -- diffuse large B‐cell lymphoma -- transformation -- outcome -- immunohistochemistry; Hematology -- Periodicals; Blood -- Diseases -- Periodicals; 616.15
• DOI: 10.1111/bjh.14153
• Languages: English
• ISSNs: 0007-1048

Abstract

Abstract : This study analysed incidence, patient outcome, immunophenotype and prognostic factors of histological transformation (HT) from extranodal marginal zone B‐cell lymphoma of mucosa‐associated lymphoid tissue (MALT lymphoma) to diffuse large B‐cell lymphoma (DLBCL) in 467 patients (median age, 61 years). The primary sites of MALT lymphoma were the stomach (43%), ocular adnexa (25%), lung (8%), systemic (8%) and other tissues (16%). HT occurred in 8% of MALT lymphomas. Risk of HT by 15 years was 5%: 4% in limited‐stage diseases ( n = 385) and 16% in advanced‐stage diseases ( n = 56) ( P = 0·02). The median time to HT was 48 months (range, 4–139). Five‐year progression‐free survival (PFS) and overall survival (OS) rates after HT were 80% and 94%, respectively. Immunohistochemical results of DLBCL were as follows: germinal centre B‐cell (GCB)/non‐GCB, 37%/63%; CD10, 9%; BCL6, 59%; MUM1, 38%; MYC, 42%; BCL2, 35%; Ki67 ≥ 90%, 23%; and CD5, 3%. The majority (75%, 9/12) of GCB‐type DLBCLs exhibited CD10 −, BCL6 + and MUM1 − immunophenotypes; the remainder had CD10 + immunophenotypes. Multivariate analysis revealed that only advanced stage at HT was a significant adverse factor for PFS ( P = 0·037). Thus, overall risk of HT was low and prognosis after HT was favourable; however, in advanced‐stage cases, risk of HT was relatively high and prognosis was unfavourable.