Journal article
Transformation in Marginal Zone Lymphoma: Results from a Prospective Cohort and a Meta-Analysis of the Literature
Blood advances, Vol.8(23), pp.5939-5948
12/10/2024
DOI: 10.1182/bloodadvances.2024013188
PMCID: PMC11629267
PMID: 39321424
Abstract
•The cumulative incidence of transformation in Marginal Zone Lymphoma is 5% at 5 years and 8% at 10 years after diagnosis•Transformation is associated with a 3.95-fold increased risk of death
Marginal zone lymphoma (MZL) includes extranodal (EMZL), splenic (SMZL), and nodal (NMZL) subtypes. Histological transformation (HT) to large B-cell lymphomas is well documented but with a large variability in published cumulative incidence rates. We report results from the Molecular Epidemiology Resource (MER) cohort for the cumulative incidence of HT (with death as competing risk) and associated risk factors and outcomes. We also conduct a meta-analysis of available studies on the cumulative incidence of HT. From 2002-2015, 529 patients with MZL were enrolled in the MER (69% EMZL, 16% SMZL, 15% NMZL). Ten-year overall survival (OS) from diagnosis was 66%. HT occurred in 21 patients, with 5-year and 10-year cumulative incidence of HT of 2.7% (95% confidence interval [CI] 0.02-0.05) and 3.6% (95%CI 0.02-0.06), respectively. HT was associated with an increased risk of death (subdistribution hazard ratio (HR)=3.95; 95%CI 2.06-7.55). Predictors of HT were ≥2 extranodal sites and MALT-IPI score ≥2. OS was 79% at 5 and 55% at 10 years after HT. Age at HT≥70 years was the only predictor of OS after HT (HR=3.57; 95%CI 1.34-9.48). In meta-analysis of 12 studies (6,161 patients), the 5- and 10-year cumulative incidence of HT across all subtypes were 5% (95%CI 0.05-0.06) and 8% (95%CI 0.07-0.09), respectively. Rates were lower in EMZL (3% and 5%) than in SMZL (7% and 13%) and NMZL (9% and 13%). While HT is relatively uncommon in the first decade after MZL diagnosis, it is associated with an inferior outcome and needs new approaches to prevention and management.
Details
- Title: Subtitle
- Transformation in Marginal Zone Lymphoma: Results from a Prospective Cohort and a Meta-Analysis of the Literature
- Creators
- Côme Bommier - Mayo ClinicBrian K. Link - University of IowaBrianna J. Gysbers - Mayo ClinicMatthew J. Maurer - Mayo ClinicMelissa C. Larson - Mayo ClinicArushi Khurana - Mayo ClinicYucai Wang - Mayo ClinicCarrie A. Thompson - Mayo ClinicDai Chihara - The University of Texas MD Anderson Cancer CenterJuan P. Alderuccio - University of MiamiJean L. Koff - Emory UniversityNarendranath Epperla - The Ohio State UniversityAnnarita Conconi - Ospedale degli InfermiIzidore S. Lossos - University of MiamiGrzegorz S. Nowakowski - Mayo ClinicAndrew L. Feldman - Mayo ClinicThomas M. Habermann - Mayo ClinicRebecca L. King - Mayo ClinicJames R. Cerhan - Mayo Clinic
- Resource Type
- Journal article
- Publication Details
- Blood advances, Vol.8(23), pp.5939-5948
- DOI
- 10.1182/bloodadvances.2024013188
- PMID
- 39321424
- PMCID
- PMC11629267
- NLM abbreviation
- Blood Adv
- ISSN
- 2473-9529
- eISSN
- 2473-9537
- Publisher
- Elsevier Inc
- Grant note
- Lymphoma InstitutePhilippe Foundation: CT0101951
Lymphoma Institute. C.B. also received funding from the Philippe Foundation and Institut Servier (CT0101951) for travel support.r Lymphoma Institute. C.B. also received funding from the Philippe Foundation and Institut Servier (CT0101951) for travel support.
- Language
- English
- Electronic publication date
- 09/25/2024
- Date published
- 12/10/2024
- Academic Unit
- Hematology, Oncology, and Blood & Marrow Transplantation; Epidemiology; Internal Medicine
- Record Identifier
- 9984721250402771
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