A population-based study of transformed marginal zone lymphoma: identifying outcome-related characteristics
Abstract Histological transformation of marginal zone lymphoma (tMZL) into diffuse large B-cell lymphoma is associated with poor outcomes. Clinical characteristics associated with transformation risk and outcome after transformation are largely unknown due to scarcity of data. In this population-bas...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Nature Publishing Group
2023-09-01
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| Series: | Blood Cancer Journal |
| Online Access: | https://doi.org/10.1038/s41408-023-00903-w |
| _version_ | 1797578050405138432 |
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| author | Johanna A. A. Bult Francien Huisman Yujie Zhong Nick Veltmaat Joost Kluiver Sanne H. Tonino Joost S. P. Vermaat Martine E. D. Chamuleau Arjan Diepstra Anke van den Berg Wouter J. Plattel Mirian Brink Marcel Nijland |
| author_facet | Johanna A. A. Bult Francien Huisman Yujie Zhong Nick Veltmaat Joost Kluiver Sanne H. Tonino Joost S. P. Vermaat Martine E. D. Chamuleau Arjan Diepstra Anke van den Berg Wouter J. Plattel Mirian Brink Marcel Nijland |
| author_sort | Johanna A. A. Bult |
| collection | DOAJ |
| description | Abstract Histological transformation of marginal zone lymphoma (tMZL) into diffuse large B-cell lymphoma is associated with poor outcomes. Clinical characteristics associated with transformation risk and outcome after transformation are largely unknown due to scarcity of data. In this population-based study, competing risk analyses were performed to elucidate clinical characteristics associated with developing transformation among 1793 MZL patients using the Netherlands Cancer Registry. Cox regression analyses were performed to elucidate clinical characteristics associated with risk of relapse and mortality after transformation. Transformation occurred in 75 (4%) out of 1793 MZL patients. Elevated LDH and nodal MZL subtype at MZL diagnosis were associated with an increased risk, and radiotherapy with a reduced risk of developing tMZL. Most tMZL patients received R-(mini)CHOP (n = 53, 71%). Age >60 years and (immuno)chemotherapy before transformation were associated with an increased risk of relapse and mortality after transformation. Two-year progression-free survival (PFS) and overall survival (OS) were 66% (95% CI 52–77%) and 75% (95% CI 62–85%) for R-(mini)CHOP-treated tMZL patients, as compared to a PFS and OS both of 41% (95% CI 19–63%) for patients treated otherwise. Our study offers comprehensive insights into characteristics associated with transformation and survival after transformation, thereby optimizing guidelines and patient counseling. |
| first_indexed | 2024-03-10T22:16:44Z |
| format | Article |
| id | doaj.art-c575b728501f4006bbbe73caea67c694 |
| institution | Directory Open Access Journal |
| issn | 2044-5385 |
| language | English |
| last_indexed | 2024-03-10T22:16:44Z |
| publishDate | 2023-09-01 |
| publisher | Nature Publishing Group |
| record_format | Article |
| series | Blood Cancer Journal |
| spelling | doaj.art-c575b728501f4006bbbe73caea67c6942023-11-19T12:25:12ZengNature Publishing GroupBlood Cancer Journal2044-53852023-09-011311710.1038/s41408-023-00903-wA population-based study of transformed marginal zone lymphoma: identifying outcome-related characteristicsJohanna A. A. Bult0Francien Huisman1Yujie Zhong2Nick Veltmaat3Joost Kluiver4Sanne H. Tonino5Joost S. P. Vermaat6Martine E. D. Chamuleau7Arjan Diepstra8Anke van den Berg9Wouter J. Plattel10Mirian Brink11Marcel Nijland12Department of Hematology, University Medical Center GroningenDepartment of Hematology, University Medical Center GroningenDepartment of Hematology, University Medical Center GroningenDepartment of Hematology, University Medical Center GroningenDepartment of Pathology and Medical Biology, University Medical Center GroningenDepartment of Hematology, Amsterdam University Medical CenterDepartment of Hematology, Leiden University Medical CenterDepartment of Hematology, Amsterdam University Medical CenterDepartment of Pathology and Medical Biology, University Medical Center GroningenDepartment of Pathology and Medical Biology, University Medical Center GroningenDepartment of Hematology, University Medical Center GroningenDepartment of Research and Development, Netherlands Comprehensive Cancer Organization (IKNL)Department of Hematology, University Medical Center GroningenAbstract Histological transformation of marginal zone lymphoma (tMZL) into diffuse large B-cell lymphoma is associated with poor outcomes. Clinical characteristics associated with transformation risk and outcome after transformation are largely unknown due to scarcity of data. In this population-based study, competing risk analyses were performed to elucidate clinical characteristics associated with developing transformation among 1793 MZL patients using the Netherlands Cancer Registry. Cox regression analyses were performed to elucidate clinical characteristics associated with risk of relapse and mortality after transformation. Transformation occurred in 75 (4%) out of 1793 MZL patients. Elevated LDH and nodal MZL subtype at MZL diagnosis were associated with an increased risk, and radiotherapy with a reduced risk of developing tMZL. Most tMZL patients received R-(mini)CHOP (n = 53, 71%). Age >60 years and (immuno)chemotherapy before transformation were associated with an increased risk of relapse and mortality after transformation. Two-year progression-free survival (PFS) and overall survival (OS) were 66% (95% CI 52–77%) and 75% (95% CI 62–85%) for R-(mini)CHOP-treated tMZL patients, as compared to a PFS and OS both of 41% (95% CI 19–63%) for patients treated otherwise. Our study offers comprehensive insights into characteristics associated with transformation and survival after transformation, thereby optimizing guidelines and patient counseling.https://doi.org/10.1038/s41408-023-00903-w |
| spellingShingle | Johanna A. A. Bult Francien Huisman Yujie Zhong Nick Veltmaat Joost Kluiver Sanne H. Tonino Joost S. P. Vermaat Martine E. D. Chamuleau Arjan Diepstra Anke van den Berg Wouter J. Plattel Mirian Brink Marcel Nijland A population-based study of transformed marginal zone lymphoma: identifying outcome-related characteristics Blood Cancer Journal |
| title | A population-based study of transformed marginal zone lymphoma: identifying outcome-related characteristics |
| title_full | A population-based study of transformed marginal zone lymphoma: identifying outcome-related characteristics |
| title_fullStr | A population-based study of transformed marginal zone lymphoma: identifying outcome-related characteristics |
| title_full_unstemmed | A population-based study of transformed marginal zone lymphoma: identifying outcome-related characteristics |
| title_short | A population-based study of transformed marginal zone lymphoma: identifying outcome-related characteristics |
| title_sort | population based study of transformed marginal zone lymphoma identifying outcome related characteristics |
| url | https://doi.org/10.1038/s41408-023-00903-w |
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