Active surveillance of primary extranodal marginal zone lymphoma of bronchus-associated lymphoid tissue Journal Article


Authors: Joffe, E.; Leyfman, Y.; Drill, E.; Rajeeve, S.; Zelenetz, A. D.; Lia Palomba, M.; Moskowitz, C. H.; Portlock, C.; Noy, A.; Horwitz, S. M.; Gerecitano, J. F.; Moskowitz, A.; Hamlin, P.; Matasar, M. J.; Kumar, A.; Batlevi, C. L.; Younes, A.; Straus, D. J.
Article Title: Active surveillance of primary extranodal marginal zone lymphoma of bronchus-associated lymphoid tissue
Abstract: Although patients with bronchus-associated lymphoid tissue (BALT) lymphoma show an indolent clinical course, appropriate disease management at diagnosis is not well defined. This study aimed to compare 3 treatment strategies for patients with BALT lymphoma: Active surveillance, systemic chemotherapy or immunotherapy at diagnosis, or complete surgical resection at diagnosis. We conducted a retrospective study of all patients with new diagnoses of marginal zone lymphoma (MZL) involving the lung who were treated at the Memorial Sloan Kettering Cancer Center between 1995 and 2017. Primary BALT lymphoma was defined as disease confined to the lungs and adjacent lymph nodes. Active surveillance was defined as a documented observation plan and $3 months of follow-up before initiating treatment. Overall survival (OS) and event-free survival (EFS) were compared between treatment groups. We reviewed 200 consecutive patients with MZL involving the lung; 123 met the inclusion criteria and were managed by active surveillance (47%), complete surgical resection (41%), or systemic chemotherapy or immunotherapy (11%). With a median followup of >60 months, surgical resection was associated with a superior EFS compared with active surveillance and systemic treatment (6-year EFS: 74% vs 65% vs 62%, respectively; P=013). Larger lesions and thrombocytopenia were associated with shorter EFS. All groups had excellent OS at 6 years (93%), albeit with a slight superiority for surgical resection (100%) over active surveillance (91%) and systemic treatment (76%) (P =.024). BALT lymphoma is an indolent disease that can often be managed expectantly and not require therapy for many years. © 2021 by The American Society of Hematology.
Journal Title: Blood Advances
Volume: 5
Issue: 2
ISSN: 2473-9529
Publisher: American Society of Hematology  
Date Published: 2021-01-26
Start Page: 345
End Page: 351
Language: English
DOI: 10.1182/bloodadvances.2020003213
PROVIDER: scopus
PMCID: PMC7839366
PUBMED: 33496731
DOI/URL:
Notes: Article -- Export Date: 1 March 2021 -- Source: Scopus
Altmetric
Citation Impact
BMJ Impact Analytics
MSK Authors
  1. Carol Portlock
    204 Portlock
  2. Craig Moskowitz
    407 Moskowitz
  3. Ariela Noy
    351 Noy
  4. Maria Lia Palomba
    415 Palomba
  5. Steven M Horwitz
    645 Horwitz
  6. Andrew D Zelenetz
    767 Zelenetz
  7. Alison Moskowitz
    339 Moskowitz
  8. Paul Hamlin
    277 Hamlin
  9. Matthew J Matasar
    289 Matasar
  10. David J Straus
    356 Straus
  11. Anita Kumar
    180 Kumar
  12. Connie Wing-Ching Lee Batlevi
    176 Batlevi
  13. Esther Naomi Drill
    93 Drill
  14. Anas Younes
    319 Younes
  15. Erel Joffe
    82 Joffe