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©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
Management of gastric mucosa-associated lymphoid tissue lymphoma in patients with extra copies of the MALT1 gene
Masaya Iwamuro, Ryuta Takenaka, Masahiro Nakagawa, Yuki Moritou, Shunsuke Saito, Shinichiro Hori, Tomoki Inaba, Yoshinari Kawai, Tatsuya Toyokawa, Takehiro Tanaka, Tadashi Yoshino, Hiroyuki Okada
Masaya Iwamuro, Hiroyuki Okada, Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama 700-8558, Japan
Ryuta Takenaka, Department of Internal Medicine, Tsuyama Chuo Hospital, Tsuyama 7080841, Japan
Masahiro Nakagawa, Department of Internal Medicine, Hiroshima City Hospital, Hiroshima 730-8518, Japan
Yuki Moritou, Department of Gastroenterology, Mitoyo General Hospital, Kanonji 7691695, Japan
Shunsuke Saito, Department of Internal Medicine, Okayama Saiseikai General Hospital, Okayama 7008511, Japan
Shinichiro Hori, Department of Gastroenterology, Shikoku Cancer Center, Matsuyama 791-0280, Japan
Tomoki Inaba, Department of Gastroenterology, Kagawa Prefectural Central Hospital, Takamatsu 7608557, Japan
Yoshinari Kawai, Department of Gastroenterology, Onomichi Municipal Hospital, Onomichi 7228503, Japan
Tatsuya Toyokawa, Department of Gastroenterology, Fukuyama Medical Center, Fukuyama 7208520, Japan
Takehiro Tanaka, Department of Pathology, Okayama University Hospital, Okayama 700-8558, Japan
Tadashi Yoshino, Department of Pathology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama 700-8558, Japan
Author contributions: Iwamuro M organized the report and drafted the article; Takenaka R, Nakagawa M, Moritou Y, Saito S, Hori S, Inaba T, Kawai Y and Toyokawa T collected the data; Tanaka T and Yoshino T critically revised the article for important intellectual content; Okada H approved the final article.
Institutional review board statement: This study was reviewed and approved by the Ethical Committee of the Okayama University Hospital, Okayama, Japan.
Informed consent statement: This study is a retrospective study using medical records, and personal information protection measures are appropriately established so that the informed consent of the subject can be exempted.
Conflict-of-interest statement: All of the authors declare that they have no conflicts of interest associated with this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Masaya Iwamuro, MD, PhD, Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-Ku, Okayama 700-8558, Japan.
pr145h2k@okayama-u.ac.jp
Telephone: +81-86-2357219 Fax: +81-86-2255991
Received: May 22, 2017
Peer-review started: May 22, 2017
First decision: June 22, 2017
Revised: July 21, 2017
Accepted: August 8, 2017
Article in press: August 8, 2017
Published online: September 7, 2017
Processing time: 110 Days and 11.6 Hours
AIM
To identify the clinical features of gastric mucosa-associated lymphoid tissue (MALT) lymphoma with extra copies of MALT1.
METHODS
This is a multi-centered, retrospective study. We reviewed 146 patients with MALT lymphoma in the stomach who underwent fluorescence in situ hybridization analysis for t(11;18) translocation. Patients were subdivided into patients without t(11;18) translocation or extra copies of MALT1 (Group A, n = 88), patients with t(11;18) translocation (Group B, n = 27), and patients with extra copies of MALT1 (Group C, n = 31). The clinical background, treatment, and outcomes of each group were investigated.
RESULTS
Groups A and C showed slight female predominance, whereas Group B showed slight male predominance. Mean ages and clinical stages at lymphoma diagnosis were not different between groups. Complete response was obtained in 61 patients in Group A (69.3%), 22 in Group B (81.5%), and 21 in Group C (67.7%). Helicobacter pylori (H. pylori) eradication alone resulted in complete remission in 44 patients in Group A and 13 in Group C. In Group B, 14 patients underwent radiotherapy alone, which resulted in lymphoma disappearance. Although the difference was not statistically significant, event-free survival in Group C tended to be inferior to that in Group A (P = 0.10).
CONCLUSION
Patients with t(11;18) translocation should be treated differently from others. Patients with extra copies of MALT1 could be initially treated with H. pylori eradication, similar to patients without t(11;18) translocation or extra copies of MALT1.
Core tip: We subdivided and retrospectively reviewed 146 patients with gastric MALT lymphoma into patients without t(11;18) translocation or extra copies of MALT1 (Group A, n = 88, 60.3%), patients with t(11;18) translocation (Group B, n = 27, 18.5%), and patients with extra copies of MALT1 (Group C, n = 31, 21.2%). Groups A and C exhibited similar clinical characteristics. Helicobacter pylori eradication alone resulted in complete remission in approximately half the patients in Group A and Group C. Consequently, patients with extra copies of MALT1 could be treated similar to patients without t(11;18) translocation or extra copies of MALT1.
