Marginal zone B-cell lymphoma: A clinical comparison of nodal and mucosa-associated lymphoid tissue types

Bharat N. Nathwani, James R. Anderson, James O. Armitage, Franco Cavalli, Jacques Diebold, Milton R. Drachenberg, Nancy L. Harris, Kenneth A. MacLennan, H. Konrad Müller-Hermelink, Fred A. Ullrich, Dennis D. Weisenburger

Research output: Contribution to journalArticle

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Abstract

Purpose: In the International Lymphoma Study Group classification of lymphoma, extranodal marginal zone B-cell lymphoma (MZL) of mucosa-associated lymphoid tissue (MALT) type is listed as a distinctive entity. How- listed as a ever, nodal MZL is provisional entity because of questions as to whether it is truly a disease or just an advanced stage of MALT-type MZL. To resolve the issue of whether primary nodal MZL without involvement of mucosal sites exists and whether it is clinically different from extranodal MALT-type lymphoma, we compared the clinical features of these two lymphomas. Patients and Methods: Five expert hematopathologists reached a consensus diagnosis of MZL in 93 patients. Seventy-three were classified as having MALT-type MZL because of involvement of a mucosal site at the time of diagnosis, and 20 were classified as having nodal MZL because of involvement of lymph nodes without involvement of a mucosal site. Results: A comparison of the clinical features of nodal MZL and MALT-type MZL showed that more patients with nodal MZL presented with advanced-stage disease (71% v 34%; P = .02), peripheral lymphadenopathy (100% v 8%; P < .001), and para-aortic lymphadenopathy (56% v 14%; P < .001) than those with MALT-type MZL. However, fewer patients with nodal MZL had a large mass (≥ 5 cm) than those with MALT-type MZL (31% v 68%; P = .03). The 5-year overall survival of patients with nodal MZL was lower than that for patients with MALT-type MZL (56% v 81%; P = .09), with a similar result for failure-free survival (28% v 65%; P = .01). Comparisons of patients with International Prognostic Index scores of 0 to 3 showed that those with nodal MZL had lower 5-year overall survival (52% v 88%; P = .025) and failure-free survival (30% v 75%; P = .007) rates than those with MALT- type MZL. Conclusion: Nodal MZL seems to be a distinctive disease entity rather than an advanced stage of MALT-type MZL because the clinical presentations and survival outcomes are different in these two types of MZL. Clinically, nodal MZL is similar to other low-grade, node-based B-cell lymphomas, such as follicular and small lymphocytic lymphomas.

Original languageEnglish (US)
Pages (from-to)2486-2492
Number of pages7
JournalJournal of Clinical Oncology
Volume17
Issue number8
StatePublished - Aug 1999

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Marginal Zone B-Cell Lymphoma
Lymphoid Tissue
Mucous Membrane
Survival
Lymphoma
B-Cell Lymphoma
B-Cell Chronic Lymphocytic Leukemia
Lymph Nodes

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Nathwani, B. N., Anderson, J. R., Armitage, J. O., Cavalli, F., Diebold, J., Drachenberg, M. R., ... Weisenburger, D. D. (1999). Marginal zone B-cell lymphoma: A clinical comparison of nodal and mucosa-associated lymphoid tissue types. Journal of Clinical Oncology, 17(8), 2486-2492.

Marginal zone B-cell lymphoma : A clinical comparison of nodal and mucosa-associated lymphoid tissue types. / Nathwani, Bharat N.; Anderson, James R.; Armitage, James O.; Cavalli, Franco; Diebold, Jacques; Drachenberg, Milton R.; Harris, Nancy L.; MacLennan, Kenneth A.; Müller-Hermelink, H. Konrad; Ullrich, Fred A.; Weisenburger, Dennis D.

In: Journal of Clinical Oncology, Vol. 17, No. 8, 08.1999, p. 2486-2492.

Research output: Contribution to journalArticle

Nathwani, BN, Anderson, JR, Armitage, JO, Cavalli, F, Diebold, J, Drachenberg, MR, Harris, NL, MacLennan, KA, Müller-Hermelink, HK, Ullrich, FA & Weisenburger, DD 1999, 'Marginal zone B-cell lymphoma: A clinical comparison of nodal and mucosa-associated lymphoid tissue types', Journal of Clinical Oncology, vol. 17, no. 8, pp. 2486-2492.
Nathwani BN, Anderson JR, Armitage JO, Cavalli F, Diebold J, Drachenberg MR et al. Marginal zone B-cell lymphoma: A clinical comparison of nodal and mucosa-associated lymphoid tissue types. Journal of Clinical Oncology. 1999 Aug;17(8):2486-2492.
Nathwani, Bharat N. ; Anderson, James R. ; Armitage, James O. ; Cavalli, Franco ; Diebold, Jacques ; Drachenberg, Milton R. ; Harris, Nancy L. ; MacLennan, Kenneth A. ; Müller-Hermelink, H. Konrad ; Ullrich, Fred A. ; Weisenburger, Dennis D. / Marginal zone B-cell lymphoma : A clinical comparison of nodal and mucosa-associated lymphoid tissue types. In: Journal of Clinical Oncology. 1999 ; Vol. 17, No. 8. pp. 2486-2492.
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abstract = "Purpose: In the International Lymphoma Study Group classification of lymphoma, extranodal marginal zone B-cell lymphoma (MZL) of mucosa-associated lymphoid tissue (MALT) type is listed as a distinctive entity. How- listed as a ever, nodal MZL is provisional entity because of questions as to whether it is truly a disease or just an advanced stage of MALT-type MZL. To resolve the issue of whether primary nodal MZL without involvement of mucosal sites exists and whether it is clinically different from extranodal MALT-type lymphoma, we compared the clinical features of these two lymphomas. Patients and Methods: Five expert hematopathologists reached a consensus diagnosis of MZL in 93 patients. Seventy-three were classified as having MALT-type MZL because of involvement of a mucosal site at the time of diagnosis, and 20 were classified as having nodal MZL because of involvement of lymph nodes without involvement of a mucosal site. Results: A comparison of the clinical features of nodal MZL and MALT-type MZL showed that more patients with nodal MZL presented with advanced-stage disease (71{\%} v 34{\%}; P = .02), peripheral lymphadenopathy (100{\%} v 8{\%}; P < .001), and para-aortic lymphadenopathy (56{\%} v 14{\%}; P < .001) than those with MALT-type MZL. However, fewer patients with nodal MZL had a large mass (≥ 5 cm) than those with MALT-type MZL (31{\%} v 68{\%}; P = .03). The 5-year overall survival of patients with nodal MZL was lower than that for patients with MALT-type MZL (56{\%} v 81{\%}; P = .09), with a similar result for failure-free survival (28{\%} v 65{\%}; P = .01). Comparisons of patients with International Prognostic Index scores of 0 to 3 showed that those with nodal MZL had lower 5-year overall survival (52{\%} v 88{\%}; P = .025) and failure-free survival (30{\%} v 75{\%}; P = .007) rates than those with MALT- type MZL. Conclusion: Nodal MZL seems to be a distinctive disease entity rather than an advanced stage of MALT-type MZL because the clinical presentations and survival outcomes are different in these two types of MZL. Clinically, nodal MZL is similar to other low-grade, node-based B-cell lymphomas, such as follicular and small lymphocytic lymphomas.",
author = "Nathwani, {Bharat N.} and Anderson, {James R.} and Armitage, {James O.} and Franco Cavalli and Jacques Diebold and Drachenberg, {Milton R.} and Harris, {Nancy L.} and MacLennan, {Kenneth A.} and M{\"u}ller-Hermelink, {H. Konrad} and Ullrich, {Fred A.} and Weisenburger, {Dennis D.}",
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T2 - A clinical comparison of nodal and mucosa-associated lymphoid tissue types

AU - Nathwani, Bharat N.

AU - Anderson, James R.

AU - Armitage, James O.

AU - Cavalli, Franco

AU - Diebold, Jacques

AU - Drachenberg, Milton R.

AU - Harris, Nancy L.

AU - MacLennan, Kenneth A.

AU - Müller-Hermelink, H. Konrad

AU - Ullrich, Fred A.

AU - Weisenburger, Dennis D.

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N2 - Purpose: In the International Lymphoma Study Group classification of lymphoma, extranodal marginal zone B-cell lymphoma (MZL) of mucosa-associated lymphoid tissue (MALT) type is listed as a distinctive entity. How- listed as a ever, nodal MZL is provisional entity because of questions as to whether it is truly a disease or just an advanced stage of MALT-type MZL. To resolve the issue of whether primary nodal MZL without involvement of mucosal sites exists and whether it is clinically different from extranodal MALT-type lymphoma, we compared the clinical features of these two lymphomas. Patients and Methods: Five expert hematopathologists reached a consensus diagnosis of MZL in 93 patients. Seventy-three were classified as having MALT-type MZL because of involvement of a mucosal site at the time of diagnosis, and 20 were classified as having nodal MZL because of involvement of lymph nodes without involvement of a mucosal site. Results: A comparison of the clinical features of nodal MZL and MALT-type MZL showed that more patients with nodal MZL presented with advanced-stage disease (71% v 34%; P = .02), peripheral lymphadenopathy (100% v 8%; P < .001), and para-aortic lymphadenopathy (56% v 14%; P < .001) than those with MALT-type MZL. However, fewer patients with nodal MZL had a large mass (≥ 5 cm) than those with MALT-type MZL (31% v 68%; P = .03). The 5-year overall survival of patients with nodal MZL was lower than that for patients with MALT-type MZL (56% v 81%; P = .09), with a similar result for failure-free survival (28% v 65%; P = .01). Comparisons of patients with International Prognostic Index scores of 0 to 3 showed that those with nodal MZL had lower 5-year overall survival (52% v 88%; P = .025) and failure-free survival (30% v 75%; P = .007) rates than those with MALT- type MZL. Conclusion: Nodal MZL seems to be a distinctive disease entity rather than an advanced stage of MALT-type MZL because the clinical presentations and survival outcomes are different in these two types of MZL. Clinically, nodal MZL is similar to other low-grade, node-based B-cell lymphomas, such as follicular and small lymphocytic lymphomas.

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