Cyclophosphamide 단일 화학요법으로 치유된 위 변연부 B 세포 림프종 2예
Two Cases of Gastric Marginal Zone B Cell Lymphoma Treated with a Single Agent Chemotherapy
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초록
위 변연부 B 세포 림프종은 H. pylori와 연관되어 발생하며, H. pylori를 박멸하면 60∼80%에서 림프종이 소실된다고 보고되고 있다. 그러나 H. pylori 제균으로 림프종이 소실되지 않는 경우는 2차 치료가 필요하며 수술, 방사선 치료, 화학요법 등이 있다. 저자들은 H. pylori 제균치료로 림프종이 소실되지 않은 환자에서 경구 단일 화학요법으로 관해에 이르고, 이후 15∼18개월간 재발 없이 추적 관찰중인 2예를 문헌고찰과 함께 보고한다.
Abstract
Gastric marginal zone B cell lymphoma of the MALT type (MALT lymphoma) is usually accompanied by a Helicobacter pylori (H. pylori) infection. Most gastric MALT lymphomas regress after the eradication of H. pylori. Therefore, H. pylori eradication therapy is an effective first-line treatment for gastric MALT lymphoma. A second-line treatment for patients who fail to respond to eradication therapy, including radiotherapy and chemotherapy, produces a good response and survival rate. We encountered 2 cases of H. pylori eradication-resistant gastric MALT lymphoma, which were treated with cyclophosphamide monotherapy. A complete response was obtained in both cases after a treatment duration of 3 months and remission continued for 15 and 18 months, respectively. Treatment-related toxicity was mild. Oral monochemotherapy might be an alternative, effective and safe treatment modality for patients with gastric MALT lymphoma who are resistant to H. pylori eradication therapy.
참고문헌 (20)
- Isaacson P, "Malignant lymphoma of mucosa-associated lymphoid tissue. A distinctive type of B-cell lymphoma", Cancer, 52, pp.1410~1416 (1983)
- Chan JK, "The new World Health Organization classification of lymphomas: the past, the present and the future", Hematol Oncol, 19, pp.129~150 (2001)
- Wotherspoon AC, "Regression of primary low-grade B-cell gastric lymphoma of mucosa-associated lymphoid tissue type after eradication of Helicobacter pylori", Lancet, 342, pp.575~577 (1993)
- Fischbach W, "Long term outcome of patients with gastric marginal zone B cell lymphoma of mucosa associated lymphoid tissue (MALT) following exclusive Helicobacter pylori eradication therapy: experience from a large prospective series", Gut, 53, pp.34~37 (2004)
- Wundisch T, "Long-term follow-up of gastric MALT lymphoma after Helicobacter pylori eradication", J Clin Oncol, 23, pp.8018~8024 (2005)
- Sackmann M, "Regression of gastric MALT lymphoma after eradication of Helicobacter pylori is predicted by endosonographic staging. MALT Lymphoma Study Group", Gastroenterology, 113, pp.1087~1090 (1997)
- 이상길, "저위도 점막연관림프조직형 위 림프종의 내시경 소견과 치료에 대한 장기 성적보고", Clinical Endoscopy, 26(4), pp.192~198 (2003), 대한소화기내시경학회
- Lee YC, "eradication and MALToma: long term results", Korean J Gastrointest Endosc, 31, pp.29~32 (2005)
- Bayerdorffer E, "Regression of primary gastric lymphoma of mucosa-associated lymphoid tissue type after cure of Helicobacter pylori infection", Lancet, 345, pp.1591~1594 (1995), MALT Lymphoma Study Group
- Schechter NR, "Treatment of mucosa- associated lymphoid tissue lymphoma of the stomach with radiation alone", J Clin Oncol, 16, pp.1916~1921 (1998)
- Tsang RW, "Localized mucosa-associated lymphoid tissue lymphoma treated with radiation therapy has excellent clinical outcome", J Clin Oncol, 21, pp.4157~4164 (2003)
- Yoon SS, "Chemotherapy is an effective first line treatment for early stage gastric mucosa-associated lymphoid tissue lymphoma", Cancer Treat Rev, 32, pp.139~143 (2006)
- Nakamura S, "Long-term clinical outcome of Helicobacter pylori eradication for gastric mucosa-associated lymphoid tissue lymphoma with a reference to second-line treatment", Cancer, 104, pp.532~540 (2005)
- Aviles A, "Is surgery necessary in the treatment of primary gastric non-Hodgkin lymphoma", Leuk Lymphoma, 5, pp.365~369 (1991)
- Koch P, "Primary gastrointestinal non-Hodgkin's lymphoma: II. Combined surgical and conservative or conservative management only in localized gastric lymphoma-results of the prospective German multicenter study GIT NHL 01", 92, 2001, pp.19, 3874~3883
- Hammel P, "Efficacy of single-agent chemotherapy in low-grade B-cell mucosa-associated lymphoid tissue lymphoma with prominent gastric expression", J Clin Oncol, 13, pp.2524~2529 (1995)
- Lepicard A, "Duodenal mucosaassociated lymphoid tissue lymphoma: treatment with oral cyclophosphamide", Am J Gastroenterol, 95, pp.536~539 (2000)
- Chin YJ, "Clinicopathologic study of primary gastric lymphoma of B-cell phenotype with special reference to low-grade B-cell lymphoma of MALT", Korean J Gastroenterol, 31, pp.463~476 (1998)
- Yokoda K, "Differential diagnosis through comparison of endoscopic findings concerning superficial gastric lymphoma and chronic gastritis", Stomach and Intestine, 36, pp.61~68 (2001)
- Yoon SS, "The diminishing role of surgery in the treatment of gastric lymphoma", Ann Surg, 240, pp.28~37 (2004)