EVALUATION OF THE INTERNATIONAL INDEX IN THE PROGNOSIS OF HIGH-GRADE GASTRIC MALT LYMPHOMA

The International Prognostic Index identifies four risk groups with di fferent survival rates in aggressive non-Hodgkin's lymphoma. We have s tudied whether a slight modification of this index has prognostic sign ificance in high grade gastric B-cell MALT lymphoma. In 53 patients wi th high grade gastric B-cell MALT lymphoma the following survival fact ors were investigated: age over or under 60 years, sex, B symptoms, mo re than one extranodal site of involvement other than the stomach, ser um LDH levels, performance status, stage I/IIE1/IIE2 v.s. stage III/IV , treatment with surgery, chemotherapy or both modalities together and the four risk groups as defined by the Modified International Prognos tic Index (MIPI). A multivariate Cox's test was used to evaluate the i ndependent prognostic significance on survival of all the above variab les. Advanced stage (III/IV) and involvement of more than one extranod al site not including stomach were the only variables influencing surv ival. The MIPI was not sufficient to separate groups with significant differences in survival or to stratify prognostic groups. In this seri es, the MIPI did not show prognostic significance in high grade gastri c B-cell MALT lymphoma.