Abstract 4137

Introduction:

There are no studies in the literature about the frequency of liver infiltration by splenic marginal zone lymphoma (SMZL). In the last review published by the International Group of SMZL (Matutes E et al, Leukemia 2008;22:487) clinical liver infiltration seems to be infrequent and it is considered, as other organ involvement, to appear during the course of the disease and confers a bad prognosis.

Objective:

To investigate in a selected sample of patients with SMZL the prevalence of liver infiltration, as well as its possible prognostic implication in survival or transformation.

Material and methods:

In the majority of our SMZL patients who underwent a splenectomy between 1995 and 2001, a liver biopsy was realised during the surgical procedure in order to investigate hepatic infiltration by lymphoma.

Results:

Forty-eight patients with SMZL were diagnosed in our center during this period; of them, 19 were splenectomized being liver biopsy performed in 16 (only in those cases that gave informed consent). Splenectomy was performed at diagnosis in 11 patients (time from diagnosis to splenectomy < 3 months). Liver biopsy was positive for SMZL infiltration in 81.3% (13/16) of the cases. Baseline demographic and clinical characteristics of both groups of patients are shown in the following table; there were no significant differences between the groups. We neither find statistical significant differences in overall survival between both groups: mean overall survival for positive and negative liver biopsy patients was 116 ± SD 13 months and 74 ± 29 months, respectively (p=0.69).

Positive liver biopsy (n=13)Negative liver biopsy (n=3)p-value
Gender (Male/Female) 6/7 1/2 0.68 
Median Age (yrs) 59 57 0.77 
Hepatitis C + — 
High LDH 7/13 1/3 0.52 
High b2-microglobulin 8/10 1/2 0.45 
Coombs Test + 0/5 1/3 0.2 
Low Albumin 2/11 0/3 0.47 
ECOG 0–1 vs 2 11 vs 2 1 vs 2 0.15 
IIL* prognostic index ≥2 5 (38%) 1 (33%) 0.86 
IPI (1 vs 2–3) 4 vs 9 0 vs 3 0.27 
Positive liver biopsy (n=13)Negative liver biopsy (n=3)p-value
Gender (Male/Female) 6/7 1/2 0.68 
Median Age (yrs) 59 57 0.77 
Hepatitis C + — 
High LDH 7/13 1/3 0.52 
High b2-microglobulin 8/10 1/2 0.45 
Coombs Test + 0/5 1/3 0.2 
Low Albumin 2/11 0/3 0.47 
ECOG 0–1 vs 2 11 vs 2 1 vs 2 0.15 
IIL* prognostic index ≥2 5 (38%) 1 (33%) 0.86 
IPI (1 vs 2–3) 4 vs 9 0 vs 3 0.27 
*

Intergruppo Italiano Linfoma (Arcaini et al, Blood 2006; 107:4643).

Conclusion:

Histological hepatic infiltration is present in almost all SMZL patients when splenectomized. In our experience, this finding has no prognostic implication. Due to the small number of patients of this study, its significance is limited but to the best of our knowledge, it is the first report that investigates the prevalence of liver infiltration in SMZL and its impact in survival. Larger series are necessary to confirm our findings.

Disclosures:

No relevant conflicts of interest to declare.

Author notes

*

Asterisk with author names denotes non-ASH members.