766 - 19-year single center experience in the management of patients with primary gastrointestinal (GI) lymphoma

Date 28 September 2012
Event ESMO Congress 2012
Session Publication Only
Topics Lymphomas
Presenter Wolfgang Fischbach
Authors W. Fischbach, N. Mueller
  • Medizinische Klinik Ii, Klinikum Aschaffenburg, 63739 - Aschaffenburg/DE

Abstract

Introduction

Primay GI lymphoma are a rare disease. Multicenter studies were, therefore, initiated in the 90ies with various published results in subgroups of GI lymphoma who were not treated within a controlled clinical trial.

Method

As a German reference center patients with GI lymphoma are regulary presented to our institution. From 1993 on, we saw 102 consecutive patients (59 male and 43 female, age 31-89 years) with primary GI lymphoma: gastric MALT lymphoma = 76 (63 stage I, 6 stage II, 7 stage III/IV); secondary high MALT lymphoma = 3; diffuse large B-cell lymphoma (DLBCL) = 14 (stage I/II/III-IV) = 8/4/2); Burkitt lymphoma = 1; intestinal follicular lymphoma (FL) grade I/II = 8 (stage I/II/III-IV = 5/1/2). Treatment strategies were as follows: MALT-lymphoma: H. pylori eradication; radiation (RTx) and/or chemotherapy (CTx) in stages ≥ II or in case of eradication failure; DLBCL: CTx except in 3 cases who were treated by H. pylori eradication only; FL: no therapy, CTx or RTx.

Results

26/47 patients (55%) with MALT lymphoma achieved complete remission (CR) after exclusive H. pylori eradication. Application of all therapeutic procedures resulted in CR = 53/76 (70%) and PR with watch-and-wait = 22/76 (29%). There was only 1 patient revealing progression. In DLBCL, 12 (86 5) achieved CR after 1-3 line therapies. In FL, watch-and-wait resulted in long-term stable disease in n = 5, CR after RTx in 1 case, and stable disease after CTx in 2 cases.

Conclusion

Despite a negative selection of patients being presented to our reference center the overall treatment results in all subgroups of GI lymphoma are excellent when all treatment options are offered in a sequential therapeutic strategy. Watch-and-wait is a promising approach in MALT lymphoma with residual disease following H. pylori eradication and in FL.

Disclosure

All authors have declared no conflicts of interest.