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Blood, 1 April 2002, Vol. 99, No. 7, pp. 2541-2544
NEOPLASIA
Molecular follow-up in gastric mucosa-associated lymphoid tissue
lymphomas: early analysis of the LY03 cooperative trial
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, and
Emanuele Zucca for the
International Extranodal Lymphoma Study Group and
the United Kingdom Lymphoma Group
From the Department of Experimental Haematology, Barts
and The London - Queen Mary's School of Medicine and Dentistry,
London, United Kingdom; Oncologia Medica, Istituto Oncologico della
Svizzera Italiana, Bellinzona, Switzerland; Divisione di Medicina
Interna, Dipartimento di Scienze Mediche, Università Amedeo
Avogadro del Piemonte Orientale, Novara, Italy; Istituto di Anatomia e
Istologia Patologica, Università dell'Insubria, Ospedale di
Circolo, Varese, Italy; Anatomia Patologica e Citologia, Ospedali
Riuniti, Bergamo, Italy; Patologia, OCS, Sondrio, Italy;
Dipartimento di Patologia, Ospedale San Raffaele, Milan, Italy;
Istituto di Patologia, Locarno, Switzerland; Universita' di Torino,
Torino, Italy; Ospedale Civile Infermi, Rimini, Italy; Centro di
Ricerca Tettamanti, Clinica Pediatrica Universita' Milano-Bicocca,
Monza, Italy; Histopathology, Royal Marsden Hospital, London, United
Kingdom; YCR Department of Clinical Oncology, Weston Park Hospital,
Sheffield, United Kingdom; MRC Clinical Trial Unit, London, United
Kingdom; Clinical Sciences, The Royal Free and University College
Medical School, London, United Kingdom.
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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