Molecular follow-up in gastric mucosa-associated lymphoid tissue lymphomas: early analysis of the LY03 cooperative trial |
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Authors: | Bertoni Francesco,Conconi Annarita,Capella Carlo,Motta Teresio,Giardini Roberto,Ponzoni Maurilio,Pedrinis Ennio,Novero Domenico,Rinaldi Paolo,Cazzaniga Giovanni,Biondi Andrea,Wotherspoon Andrew,Hancock Barry William,Smith Paul,Souhami Robert,Cotter Finbarr E,Cavalli Franco,Zucca Emanuele International Extranodal Lymphoma Study Group United Kingdom Lymphoma Group |
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Affiliation: | Department of Experimental Haematology, Barts and The London-Queen Mary's School of Medicine and Dentistry, London, United Kingdom. frbertoni@tin.it |
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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. |
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