RT Journal Article
SR Electronic
T1 Treatment of Mucosa-associated Lymphoid Tissue Lymphoma in Sjögren’s Syndrome: A Retrospective Clinical Study
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP 2198
OP 2208
DO 10.3899/jrheum.110077
VO 38
IS 10
A1 RODNEY P.E. POLLARD
A1 JUSTIN PIJPE
A1 HENDRIKA BOOTSMA
A1 FRED K.L. SPIJKERVET
A1 PHILIP M. KLUIN
A1 JAN L.N. ROODENBURG
A1 CEES G.M. KALLENBERG
A1 ARJAN VISSINK
A1 GUSTAAF W. van IMHOFF
YR 2011
UL http://www.jrheum.org/content/38/10/2198.abstract
AB Objective. To retrospectively analyze the clinical course of patients with mucosa-associated lymphoid tissue (MALT)-type lymphoma of the parotid gland and associated Sjögren’s syndrome (SS). Methods. All consecutive patients with SS and MALT lymphoma (MALT-SS) diagnosed in the University Medical Center Groningen between January 1997 and January 2009 were analyzed. Clinical course and treatment outcome of SS and MALT lymphoma were evaluated. Results. From a total of 329 patients with SS, 35 MALT-SS patients were identified, with a median followup of 76 months (range 16–153 mo). MALT lymphoma was localized in the parotid gland in all cases. Treatment consisted of “watchful waiting” (n = 10), surgery (n = 3), radiotherapy (n = 1), surgery combined with radiotherapy (n = 2), rituximab only (n = 13), or rituximab combined with chemotherapy (n = 6). Complete response was observed in 14 patients, partial response in 1 patient, and stable disease in 20 patients. In 6 of 7 patients with initially high SS disease activity (M-protein, cryoglobulins, IgM rheumatoid factor > 100 KIU/l, severe extraglandular manifestations), MALT lymphoma progressed and/or SS disease activity increased after a median followup of 39 months (range 4–98 mo), necessitating retreatment. Only 1 patient with MALT who had low SS disease activity showed progression of lymphoma when left untreated. Conclusion. An initially high SS disease activity likely constitutes an adverse prognostic factor for progression of lymphoma and/or SS. Such patients may require treatment for both MALT lymphoma and SS. In SS patients with localized asymptomatic MALT lymphoma and low SS disease activity, a “watchful waiting” strategy seems justified.