Marginal zone lymphomas: Factors that affect the final outcome

Ali Mazloom, L. Jeffrey Medeiros, Peter W. McLaughlin, Valerie Reed, Fernando F. Cabanillas, Luis E. Fayad, Barbara Pro, Graciela Gonzalez, Puneeth Iyengar, Diana L. Urbauer, Bouthaina S. Dabaja

Research output: Contribution to journalArticlepeer-review

38 Scopus citations

Abstract

BACKGROUND: A retrospective review and analysis of 275 patients with marginal zone lymphoma (MZL) was performed to determine prognostic factors. An effort was also made to establish a specific prognostic score for patients with extranodal MZL. METHODS: Patients were divided into 3 groups according to the type of MZL: extranodal, nodal, and splenic. Factors analyzed included age; gender; presence of B symptoms; Zubrod performance score; clinical stage; serum β2-microglobulin, lactate dehydrogenase, albumin, and hemoglobin levels; and presence of autoimmune disorder. RESULTS: The 5-year overall survival rates of patients with extranodal, nodal, and splenic MZL were 87%, 89%, and 93%, respectively (P = .95). On multivariate analysis, splenic MZL patients had the best prognosis (hazard ratio, 0.18; P = .018). An elevated serum β2-microglobulin level (P = .010), B symptoms (P = .021), and male gender (P = .036) were found to be correlated with decreased recurrence-free survival (RFS) on multivariate analysis. Using these 3 variables, a 3-tier prognostic scoring system was created for patients with extranodal MZL: low-risk with no adverse factors, intermediate-risk with 1 adverse factor, and high-risk with ≥2 adverse factors. The 5-year RFS rates for the low-risk, intermediate-risk, and high-risk groups were 80%, 71%, and 44%, respectively (P = .01). CONCLUSIONS: Patients with extranodal and nodal MZL have a similar prognosis, whereas patients with splenic MZL have a better prognosis despite the increased prevalence of negative prognostic indicators. With the use of 3 readily available factors, a prognostic scoring system was identified for patients with extranodal MZL.

Original languageEnglish (US)
Pages (from-to)4291-4298
Number of pages8
JournalCancer
Volume116
Issue number18
DOIs
StatePublished - Sep 15 2010

Keywords

  • Extranodal
  • Marginal zone lymphoma
  • Mucosa-associated lymphoid tissue
  • Nodal
  • Prognostic factors
  • Splenic

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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