P2-21-2EFFICACY OF RITUXIMAB MONO-THERAPY ON BRONCHIAL-ASSOCIATED LYMPHOID TISSUE LYMPHOMA

Abstract Introduction: Bronchial-associated lymphoid tissue (BALT) lymphoma is a primary pulmonary B-cell lymphoma. It has an indolent course, with a survival rate of 80% to 95% for 5 years from diagnosis, but progression-free survival is relatively short. There is no consensus on the standard initial treatment for BALT lymphoma. The purpose of this study is to assess the optimal treatment for this rare disease. Patients: We retrospectively studied a total of 8 cases with biopsy-proven BALT lymphoma from August 2003 to March 2013 in 3 institutions. The original study was carried out by Shizuoka Cancer Center. This study includes Shizuoka Cancer Center, Nishigunma National Hospital and Hiroshima University Hospital. Methods: There were 4 men and 4 women, median age 59 years (range, 32–74 years); Five were asymptomatic at diagnosis. In the remaining 3 cases, non-specific pulmonary complaints such as sputum and dyspnea were observed. Five patients had only unilateral lung disease, 3 had bilateral locations and 2 had bone marrow involvement. All patients treated primarily with rituximab mono-therapy, intravenous rituximab 375 mg/m2 per day was added for 4 to 8 cycles. Five achieved complete remission (CR) and 1 had partial response (PR), while the remaining 2 had stable disease (SD). One SD patient, who had dyspnea, received chemotherapy with mitoxantrone plus cladribine and rituximab obtained PR. The remaining non-CR patients had no symptoms, so we decided to observe then with no therapy. All 8 patients were alive during the median follow-up period of 58 months (range, 2-124 months). Results: BALT lymphoma has an indolent nature with favorable prognosis. Intensive chemotherapy may not be necessary. Rituximab mono-therapy may be enough treatment to control symptoms. We will continue to follow these 8 cases and will report on any new additional cases.