BLOOD RESEARCH

The Korean Society of Hematology (대한혈액학회)
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Clinical presentation and treatment outcomes of primary ocular adnexal MALT lymphoma in Thailand

  • Seresirikachorn, Kasem (Department of Ophthalmology, Faculty of Medicine, Chiang Mai University) ;
  • Norasetthada, Lalita (Department of Medicine, Division of Hematology, Faculty of Medicine, Chiang Mai University) ;
  • Ausayakhun, Sakarin (Department of Ophthalmology, Faculty of Medicine, Chiang Mai University) ;
  • Apivatthakakul, Atitaya (Department of Ophthalmology, Faculty of Medicine, Chiang Mai University) ;
  • Tangchittam, Sirima (Department of Ophthalmology, Faculty of Medicine, King Chulalongkorn Memorial Hospital) ;
  • Pruksakorn, Vannakorn (Department of Ophthalmology, Faculty of Medicine, King Chulalongkorn Memorial Hospital) ;
  • Wudhikarn, Kitsada (Department of Medicine, Division of Hematology, Faculty of Medicine, King Chulalongkorn Memorial Hospital) ;
  • Wiwatwongwana, Damrong (Department of Ophthalmology, Faculty of Medicine, Chiang Mai University)
  • Received : 2018.08.02
  • Accepted : 2018.08.27
  • Published : 2018.12.31
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Abstract

Background Primary ocular adnexal extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (POML) is the most common subtype of lymphoma involving the eyes in Thailand. We sought to assess the characteristics and treatment outcomes of patients with POML in Thailand. Methods We retrospectively reviewed patient data and included patients diagnosed with POML between January 2004 and December 2016 at Chiang Mai University Hospital and King Chulalongkorn Memorial Hospital, Thailand. We collected and analyzed patients' clinical characteristics and treatment outcomes. Results Among 146 patients with lymphoma involving the eyes, 121 (82%) were diagnosed with POML. Sixty-four (52.9%) were women with median age 58 (range, 22-86) years. The most common presenting symptom was orbital mass (71.1%). Common sites of origin were the orbit (46.3%) and lacrimal gland (34.7%). At presentation, 22.3% of patients had bilateral eye involvement. About half of patients had stage I disease (N=59, 56.2%) and 20% had stage IV. Most patients (73.3%) had a low-risk International Prognostic Index. Radiotherapy was the main treatment for patients with limited-stage disease (66.7% in stage I and 56.5% in stage II). The overall response rate was 100% with complete response rates 80%, 77.3%, and 64.7% for stages I, II, and IV, respectively. Five-year progression-free survival (PFS) and overall survival were 66.1% and 94.0%, respectively. For patients with limited-stage disease, radiotherapy significantly improved PFS compared with treatment not involving radiotherapy (5-year PFS 89.9% vs. 37.3%, P=0.01). Conclusion We revealed that POML has good response to treatment, especially radiotherapy, with excellent long-term outcome.

Keywords

References

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