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Prognostic Value of Translocation t(11;18) in Tumoral Response of Low-Grade Gastric Lymphoma of Mucosa-Associated Lymphoid Tissue Type to Oral Chemotherapy

From the Service d'Hépatologie et de Gastroentérologie, Département de pathologie et Institut National de la Santé et de la Recherche Médicale Unité 617, Service d'Immunologie biologique, Service d'Hématologie, and Service de Biostatistiques et d'Informatique, Hôpital Henri Mondor, Créteil, France

Address reprint requests to Michaël Levy, MD, Service d'Hépatologie et de Gastroentérologie, Hôpital Henri Mondor, 51 avenue du Maréchal de Lattre de Tassigny, 94000 Créteil, France; e-mail: michalevy{at}free.fr

PURPOSE: To determine the impact of translocation t(11;18) on response to oral alkylating agents in gastric mucosa-associated lymphoid tissue lymphoma (GML).

PATIENTS AND METHODS: Fifty-three patients with a GML were studied. Helicobacter pylori--positive patients (n = 34) received anti–H pylori treatment and H pylori–negative patients (n = 19) or patients who failed to respond to anti–H pylori treatment received oral alkylating agents. t(11;18) was detected by reverse transcription polymerase chain reaction from frozen gastric biopsies.

RESULTS: t(11;18) was detected in 32% of patients. It was more prevalent in H pylori--negative as compared with H pylori--positive patients (12 of 19 v five of 34 patients; P = .0005). Among 31 H pylori–eradicated patients, t(11;18) was detected in three patients, all of whom experienced treatment failure, and it was absent in 28 patients: 21 patients (75%) were in remission and seven patients (25%) experienced treatment failure (P = .03). Among 21 patients who received an alkylating agent, t(11;18) was detected in 12 patients: five patients (42%) were in remission and seven patients (58%) experienced treatment failure. t(11;18) was absent in nine patients: eight patients (89%) were in remission and one patient (11%) experienced treatment failure by the end of treatment. Four patients in remission relapsed during follow-up (median, 7 years): they all had t(11;18). Durable remission was obtained in eight (89%) of the nine patients without t(11;18) versus one of the 12 patients (8%) with t(11;18) (P = .0003).

CONCLUSION: Presence of t(11;18) in GML is predictive of resistance to oral alkylating agents, with less than 10% of durable remission at long-term follow-up.

Presented in part at the 12th United European Gastroenterology Week, September 25-29, 2004, Prague, Czech Republic, September 27, 2004, as an oral communication.

Authors' disclosures of potential conflicts of interest are found at the end of this article.

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