The indolent course and high incidence of t(14;18) in primary duodenal follicular lymphoma

Ann Oncol. 2010 Jul;21(7):1500-1505. doi: 10.1093/annonc/mdp557. Epub 2009 Dec 18.

Abstract

Background: Information on the clinical behavior of the recently proposed primary duodenal follicular lymphoma (DFL) is limited.

Patients and methods: Demographic data, signs, symptoms, disease stage, and treatment of the patients diagnosed in National Cancer Center Hospital from 1999 to 2007 were collected and analyzed.

Results: Twenty-seven patients were studied. Nineteen patients were asymptomatic at the time of diagnosis. Twenty patients had stage I disease. The histological grade was 1 or 2 in 26 patients. IgH/BCL2 fusion was shown in 20 of the examined 24 cases (83%). Fourteen patients received therapy upon diagnosis (local radiotherapy in 2 patients and chemotherapy in 12 including rituximab therapy), their response rate was 85%, and the estimated progression-free survival (PFS) rate at 3 years was 70%. One patient developed histological transformation. The other 13 patients were followed up; their estimated PFS rate at 3 years was 74%. Five among six cases responded to treatment even after progressive disease. All 27 patients have survived with a median follow-up time of 47.9 months.

Conclusions: The majority of primary DFL patients have a localized tumor of low-grade histology and are positive for t(14;18). Watchful waiting might be an alternative approach for its indolent course; however, further studies are warranted.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Chromosomes, Human, Pair 14 / genetics*
  • Chromosomes, Human, Pair 18 / genetics*
  • Cytogenetic Analysis
  • Disease Progression
  • Duodenal Neoplasms / genetics*
  • Duodenal Neoplasms / pathology
  • Duodenal Neoplasms / therapy
  • Female
  • Humans
  • Incidence
  • Lymphoma, Follicular / genetics*
  • Lymphoma, Follicular / pathology
  • Lymphoma, Follicular / therapy
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / genetics*
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Recurrence, Local / therapy
  • Neoplasm Staging
  • Radiotherapy Dosage
  • Retrospective Studies
  • Survival Rate
  • Translocation, Genetic / genetics*
  • Treatment Outcome