| Objective:This study aims to investigate the clinical features,chromosomal variation and prognostic factors affecting overall survival(OS)and progression-free survival(PFS)of patients with mucosa-associated Lymphoid tissue lymphoma(MALT).Methods:This is a retrospective analysis of 117 patients with MALT lymphoma treated in our hospital from May 1st,2010 to September 30 th,2020.All cases were risk stratified by MALT-IPI scoring system,Staging and efficacy evaluation were conducted according to Lugano staging criteria and efficacy evaluation criteria(2014 edition),univariate analysis and multivariate analysis were performed for clinical features,laboratory indicators,and treatment.Results:1.Clinical features: Among all the patients,there were 61 males(52.1%)and 56females(47.8%),with a male to female ratio of 1.1:1 and a median age of 54(27-85)years.The primary site was mainly found in the gastrointestinal tract(34 cases,29.1%),lung and bronchus(29 cases,24.8%).The main clinical manifestations were body surface mass(33 cases,28.2%),followed by abdominal pain and melena(30 cases,25.6%),only5 cases were accompanied by lymphoma group B symptoms.Among all the patients,66 were in Lugano stage I-II and 51 were in stage III-IV.MALT-IPI score indicated that 58 patients were at low risk,49 at medium risk,and 10 at high risk.ECOG score≥2 in 4cases.2.Survival:We obtained complete follow-up data of 113 patients(96.6%),with a median follow-up time of 34(3-127)months,of which 17 patients(15.0%)relapsed or progressed,and 5 died.Survival analysis of 113 patients showed that 3-year OS and 5-year OS were 97.2% and 94.8%,and 3-year PFS and 5-year OS were 83.5% and 78.8%,respectively.Further analysis of PFS and OS in different sites showed that the PFS in other sites group was the best(96.1%),followed by bronchial lung group(81.3%)and gastrointestinal group(59.4%),but there was no statistical difference in OS among the three groups.3.Chromosome variation:The API2/MALT1 fusion gene was detected in 15 patients,and 6 patients(40%)were positive.Triploid or tetraploid chromosomes 3,7,and 12 were detected in 10 of the 15 patients.The IGH-MALT fusion gene test was negative in all the15 patients.4.Univariate:Symptoms B(P < 0.001),Lugano staging(P=0.007),surgical treatment(P=0.038),CR after first-line treatment(P=0.045)were associated with OS;Primary site(P=0.023),Lactate dehydrogenase(LDH)(P=0.001),Lugano stage(P=0.027),MALT-IPI score(P=0.025),surgical treatment(P=0.024),Helicobacter pylori(Hp)infection(P=0.020),and CR after first-line treatment(P=0.002)were associated with PFS.5.Multivariate:Symptoms B was an independent risk factor for OS of MALT lymphoma(HR:9.179,P=0.028).With large cell transformation(HR:7.460,P=0.022),elevated LDH(HR:17.115,P < 0.001),high Lugano stage(HR:5.589,P=0.005),and Hp infection(HR:7.570,P=0.002)were independent risk factors affecting PFS of MALT lymphoma.Conclusion: 117 patients with MALT lymphoma were enrolled in this study,the median age was 54 years old,,and most patients were in remission.The survival period of the patients was long,but there was a certain recurrence rate.B Symptoms(P < 0.001),Lugano staging(P=0.007),surgical treatment(P=0.038),CR after first-line treatment(P=0.045)were related factors affecting OS;Primary site(P=0.023),LDH level(P=0.001),Lugano stage(P=0.027),MALT-IPI score(P=0.025),surgical treatment(P=0.024),Hp infection(P=0.020),CR after the first line(0.002)were the related factors affecting PFS.B symptom was independent risk factors for MALT lymphoma OS(HR:9.179,P=0.028).With large cell transformation (HR:7.460,P=0.022),elevated LDH(HR:17.115,P < 0.001),high Lugano stage(HR:5.589,P=0.005),with Hp infection(HR:7.570,P=0.002)were independent risk factors for PFS in MALT lymphoma patients. |
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