Mucosa-associated lymphoid tissue lymphoma is a disseminated disease in one third of 158 patients analyzed

Mucosa-associated lymphoid tissue-derived lymphoma (MALT lymphoma) is usual ly a very indolent lymphoma, described as localized at diagnosis and remain ing localized for a prolonged period; dissemination occurs only after a lon g course of evolution. In our database, out of 158 patients with MALT lymph oma, 54 patients presented with a disseminated disease at diagnosis. Of the se 54 patients, 17 patients (30%) presented with multiple involved mucosal sites; 37 patients (70%) presented with 1 involved mucosal site, but in 23 of these patients (44%), dissemination of the disease was due to bone marro w involvement; 12 patients (22%) had multiple lymph node involvement; and 2 patients (4%) had nonmucosal site involvement. No significant difference i n clinical characteristics (sex, age, performance status, B symptoms) and b iological parameters (hemoglobin [Hb] and lactate dehydrogenase levels) was observed between localized or disseminated MALT-lymphoma patients. Only be ta 2-microglobulin level was significantly more elevated in disseminated di sease patients than in localized disease patients. Complete response after the first treatment was achieved In 74% of the patients, and there was no d ifference between the 2 groups. With a median follow-up of 4 years, the est imated 5- and 10-year overall survival rates were similar in the 2 groups, 86% and 80%, respectively. The median freedom-from-progression survival was 5.6 years for ail patients, surprisingly without any difference between lo calized and disseminated MALT-lymphoma patients. In conclusion, MALT lympho ma is an indolent disease but presents as a disseminated disease in one-thi rd of the cases at diagnosis, The dissemination does not change the outcome of the patients. (C) 2000 by The American Society of Hematology.