Abstract
Introduction
In order to investigate the clinical and certain laboratory features of mucosa-associated lymphoid tissue (MALT) lymphoma patients with immunoglobulin (Ig) paraproteinemia and identify the potential prognostic value of Ig paraproteinemia in MALT lymphoma.
Methods
we reviewed the medical records of all patients diagnosed with MALT lymphoma and performed Ig paraprotein test at the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital from April 2010 to December 2016. A total of 115 patients were diagnosed with MALT lymphoma, of which 78 patients had been tested for serum Ig paraprotein. The correlations between serum Ig paraprotein and other prognostic factors were analyzed. Univariate and cox regression analyses were used to assess associations between survival time and potential risk factors.
Results
Among 78 MALT lymphoma cases, 16 (20.5%) had Ig paraproteinemia, mostly IgM-K (5, 31.3%), followed by IgM-L, IgG-L, IgM-K/IgA-K, IgA-L, IgM-L/IgA-L. According to the correlation analysis, male (P=0.022), advanced Ann Arbor stage (P <0.001), lymph nodes involvement (P <0.001), high level of serum β2-microglobulin (P <0.001) and low level of serum albumin (P= 0.001) were significantly related to the presence of Ig paraproteinemia. Survival analysis illustrated that patients with IgM paraproteinemia had significantly shorter progression-free survival (PFS) (P=0.005) than those without IgM paraproteinemia (Figure 1). Cox regression analysis showed that IgM paraproteinemia was an independent prognostic factor for PFS of MALT lymphoma patients (P=0.037). Risk stratification based on IPI together with IgM paraproteinemia could divide patients with MALT lymphoma into four groups and better identify high or low risk of PFS (P <0.0001) and OS (P <0.0001) in MALT lymphoma patients (Figure 2).
Conclusion
MALT lymphoma patients with Ig paraproteinemia represent a subgroup with inferior PFS. Serum Ig paraprotein might be applied for the assessment of prognosis in patients with MALT lymphoma.
No relevant conflicts of interest to declare.
