scholarly journals Hepatic Infiltration by Splenic Marginal Zone Lymphoma in a Patient With Cured Hepatitis C

Cureus ◽  
2021 ◽  
Author(s):  
Leonor Silva ◽  
Mafalda Alpoim ◽  
Ana Ribeiro ◽  
Pedro Caiano Gil ◽  
Rute Lopes Caçola
Keyword(s):  
Hepatitis C ◽  
Marginal Zone ◽  
Marginal Zone Lymphoma ◽  
Splenic Marginal Zone Lymphoma

Role of Rituximab in the Treatment of Splenic Marginal Zone Lymphoma.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 4694-4694
Author(s):  
Saaib Al Shehadat ◽  
Martin A. Bast ◽  
Gene Sehi ◽  
Greory R. Bociek ◽  
Anne Kessinger ◽  
...  
Keyword(s):  
Hepatitis C ◽  
Complete Remission ◽  
Lymph Nodes ◽  
Marginal Zone ◽  
Objective Response ◽  
B Cell Lymphoma ◽  
Marginal Zone Lymphoma ◽  
Cytotoxic Agents ◽  
Aggressive Lymphoma ◽  
Splenic Marginal Zone Lymphoma

Abstract Background: Splenic marginal zone lymphoma (SMZL) is a rare malignancy accounting for less than 1% of all lymphomas. The tumor involves the spleen, splenic hilar lymph nodes, bone marrow, and often the peripheral blood. The peripheral lymph nodes are not typically enlarged. Patients typically have circulating neoplastic cells characterized by cytoplasmic projections, round or oval nuclei and clumped chromatin. The lymphoma cells express CD19, CD20, and CD22 but not usually CD5, CD10, CD23, CD25, CD43, CD103 or cyclin D1. The tumor may be surprisingly resistant to chemotherapy that would ordinarily be effective for chronic lymphocytic leukemia. For patients needing treatment, splenectomy is the usual first treatment, which may be followed by prolonged remission. The best approach for patients following splenectomy is not clear. Methods: The characteristics of seven patients with SMZL who progressed after splenectomy are shown in the table. Six of the seven patients received rituximab therapy alone or in combination with other cytotoxic agents. One patient was ineligible for rituximab therapy due to hepatitis C. Results: One patient who relapsed 16 months after splenectomy to diffuse large B cell lymphoma (DLBCL) achieved a complete remission after 6 cycles of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) and then electively underwent autologous peripheral stem cell transplantation. His remission persisted 72+ months later. The two patients who received rituximab in combination with other cytotoxic agents 2 months after splenectomy (one had CNOP/cyclophosphamide, mitoxantrone, vincristine, and prednisone; and one had CVP/cyclophosphamide, vincristine, prednisone) remained in remission 52+ months. One patient with anemia refractory to splenectomy responded to 4 cycles of rituximab. One patient who developed anemia and monoclonal gammopathy post splenectomy received 8 weekly cycles of rituximab. Although anemia improved there was no objective response. One patient’s disease transformed to DLBCL 18 months post splenectomy, and did not respond to 8 cycles of rituximab. Conclusion: These results suggest that SMZL in patients who relapsed after splenectomy transforms to aggressive lymphoma more commonly than several thought. Most patients respond to rituximab containing regimens and may achieve a prolonged remission. More studies are warranted to investigate whether rituximab therapy shortly after splenectomy provides better progression free survival than treatment after relapse. Patients’ Characteristics 1 2 3 4 5 6* 7 F: female, CR: complete remission, M: male, P: progression, PR: partial remission, * Hepatitis C. Age 62 33 53 53 67 55 67 Sex M M F F F M F Year 1997 1998 2000 2001 2001 2001 2002 CD20 + + + + + + + DLBCL Transformation + - - - - - + Rituximab # of Cycles 6 8 4 4 6 0 8 Concurrent Chemotherapy CHOP CNOP - Fludarabine CVP CHOP - Response CR CR CR PR CR CR P Follow up (Months) 72+ 61+ 49+ 50+ 50+ 52+ 0

Outcomes In Splenic Marginal Zone Lymphoma: Analysis Of 108 Patients Treated In British Columbia (BC)

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 4369-4369
Author(s):  
Katharine He Xing ◽  
Amrit Kahlon ◽  
Joseph M. Connors ◽  
Brian Skinnider ◽  
Randy D. Gascoyne ◽  
...  
Keyword(s):  
British Columbia ◽  
Hepatitis C ◽  
Research Funding ◽  
Marginal Zone ◽  
B Cell Lymphoma ◽  
Marginal Zone Lymphoma ◽  
Transformation Rate ◽  
Splenic Marginal Zone Lymphoma ◽  
First Line

Abstract Introduction Splenic marginal zone lymphoma (SMZL) is uncommon and accounts for less than 1% of all non-Hodgkin lymphomas. The optimal treatment for SMZL is unknown. We describe the outcome of 108 patients with SMZL treated in British Columbia. Methods All patients with SMZL diagnosed between 1985 and June 2012 were identified in the BC Cancer Agency Centre for Lymphoid Cancer and Lymphoma Pathology Databases. Overall survival (OS) was measured from time of diagnosis to death or last follow-up. Progression-free survival (PFS) was measured from the date of diagnosis to the date of lymphoma recurrence or transformation, or death. Time to transformation (TTT) was calculated from date of diagnosis to date of transformation to aggressive lymphoma. Results 108 patients were identified with a diagnosis of SMZL. Baseline patient characteristics: median age 67 years (range 30-88), male 41%, stage IV 98%, B symptoms 17%, performance status ≥2 22%, splenomegaly 93%, bone marrow involvement 93%, peripheral blood involvement 87%. Hepatitis C serology was positive in 5 of 60 patients with available data. As initial treatment, 53 underwent splenectomy (10 with chemotherapy), 38 chemotherapy alone (21 with a rituximab-containing regimen), 2 received antiviral therapy for hepatitis C, and 15 were observed. Of the 43 patients who had splenectomy alone, 9 subsequently received chemotherapy upon progression, 1 had excision for a soft tissue mass, and 4 transformed to diffuse large B cell lymphoma (DLBCL). Of the 38 who received chemotherapy first line, 6 subsequently received combined chemotherapy and splenectomy, 1 splenectomy alone, 4 chemotherapy alone, and 7 transformed to DLBCL. Neither of the 2 patients who received antivirals had further progression. With a median follow-up of 7 years (range 3 months to 18 years) for living patients, the 5 and 10 year OS were 65% and 48%, respectively. The 5 and 10 year PFS were 38% and 18%, respectively. The 5 year OS for patients who had a splenectomy as their first-line therapy compared to other treatments was 76% vs 53% (p=0.01); and the 5 year OS for patients who received chemotherapy alone as first-line compared to other treatments was 52% vs 72% (p=0.04). There was no difference in outcomes between those treated with rituximab containing chemotherapy as first line compared to other treatments (p=0.65). The 5 and 10 year PFS after first-line splenectomy were 52% and 18%, respectively. A total of 14 patients transformed to DLBCL with a median TTT of 3.2 years (range 6 months to 11.9 years). The 5, 10, 15 year rates of transformation were 9%, 21% and 35%, respectively. Conclusions Splenectomy remains a reasonable treatment option for patients with SMZL. Patients selected for splenectomy as initial management of symptomatic disease experience improved outcomes. The transformation rate in SMZL is similar to that of other indolent lymphomas. Disclosures: Connors: F Hoffmann-La Roche: Research Funding; Roche Canada: Research Funding. Skinnider:Roche Canada: Research Funding. Gascoyne:Roche Canada: Research Funding. Sehn:Roche Canada: Research Funding. Savage:Roche Canada: Research Funding. Slack:Roche Canada: Research Funding. Shenkier:Roche Canada: Research Funding. Klasa:Roche Canada: Research Funding. Gerrie:Roche Canada: Research Funding. Villa:Roche Canada: Research Funding.

Mortality and Transformation Risk-Factors in Hepatitis C Negative Splenic Marginal Zone Lymphoma

2019 ◽  
Vol 19 ◽  
pp. S311
Author(s):  
Sergio Brasil ◽  
Jamilla Cavalcante ◽  
Maria Purini ◽  
Roberto Paes ◽  
Rodolfo Cancado
Keyword(s):  
Risk Factors ◽  
Hepatitis C ◽  
Marginal Zone ◽  
Marginal Zone Lymphoma ◽  
Splenic Marginal Zone Lymphoma

Regression of advanced non-splenic marginal zone lymphoma after treatment of hepatitis C virus infection

2005 ◽  
Vol 46 (9) ◽  
pp. 1365-1368 ◽  
Author(s):  
Jakub Svoboda ◽  
Charalambos Andreadis ◽  
Lisa H Downs ◽  
Wallace T Miller, Jr ◽  
Donald E Tsai ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Virus Infection ◽  
Marginal Zone ◽  
Marginal Zone Lymphoma ◽  
Splenic Marginal Zone Lymphoma ◽  
Hepatitis C Virus Infection

Hepatitis C virus infection and locally advanced splenic marginal zone lymphoma

2007 ◽  
Vol 13 (4) ◽  
pp. 382-384 ◽  
Author(s):  
Bartlomiej Szynglarewicz ◽  
Rafał Matkowski ◽  
Zbigniew Smorag ◽  
Jozef Forgacz ◽  
Marek Pudelko ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Virus Infection ◽  
Marginal Zone ◽  
Locally Advanced ◽  
Marginal Zone Lymphoma ◽  
Splenic Marginal Zone Lymphoma ◽  
Hepatitis C Virus Infection
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