766 - 19-Year Single Center Experience in the Management of Patients with Primary Gastrointestinal (GI) Lymphoma

Abstract

ABSTRACT Introduction Primay GI lymphoma are a rare disease. Multicenter studies were, therefore, initiated in the 90ies with various published results in subgroups of GI lymphoma who were not treated within a controlled clinical trial. Method As a German reference center patients with GI lymphoma are regulary presented to our institution. From 1993 on, we saw 102 consecutive patients (59 male and 43 female, age 31-89 years) with primary GI lymphoma: gastric MALT lymphoma = 76 (63 stage I, 6 stage II, 7 stage III/IV); secondary high MALT lymphoma = 3; diffuse large B-cell lymphoma (DLBCL) = 14 (stage I/II/III-IV) = 8/4/2); Burkitt lymphoma = 1; intestinal follicular lymphoma (FL) grade I/II = 8 (stage I/II/III-IV = 5/1/2). Treatment strategies were as follows: MALT-lymphoma: H. pylori eradication; radiation (RTx) and/or chemotherapy (CTx) in stages ≥ II or in case of eradication failure; DLBCL: CTx except in 3 cases who were treated by H. pylori eradication only; FL: no therapy, CTx or RTx. Results 26/47 patients (55%) with MALT lymphoma achieved complete remission (CR) after exclusive H. pylori eradication. Application of all therapeutic procedures resulted in CR = 53/76 (70%) and PR with watch-and-wait = 22/76 (29%). There was only 1 patient revealing progression. In DLBCL, 12 (86 5) achieved CR after 1-3 line therapies. In FL, watch-and-wait resulted in long-term stable disease in n = 5, CR after RTx in 1 case, and stable disease after CTx in 2 cases. Conclusion Despite a negative selection of patients being presented to our reference center the overall treatment results in all subgroups of GI lymphoma are excellent when all treatment options are offered in a sequential therapeutic strategy. Watch-and-wait is a promising approach in MALT lymphoma with residual disease following H. pylori eradication and in FL. Disclosure All authors have declared no conflicts of interest.