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Updated: Apr 3, 2026

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Histologic transformation in marginal zone lymphomas†.

A Conconi1, S Franceschetti2, K Aprile von Hohenstaufen3

  • 1Division of Hematology, Department of Translational Medicine, Amedeo Avogadro University of Eastern Piedmont, A.O.U. Maggiore della Carità, Novara Hematology Unit, Department of Internal Medicine, Ospedale degli Infermi, Biella, Italy annarita.conconi@aslbi.piemonte.it.

Annals of Oncology : Official Journal of the European Society for Medical Oncology
|September 25, 2015
PubMed
Summary

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This summary is machine-generated.

Histologic transformation (HT) in marginal zone lymphoma (MZL) is uncommon, occurring in 3.8% of patients. Elevated lactate dehydrogenase (LDH) at diagnosis is a risk factor for HT, impacting overall survival.

Area of Science:

  • Hematology
  • Oncology
  • Lymphoma Research

Background:

  • Histologic transformation (HT) is a poorly understood event in patients with marginal zone lymphoma (MZL).
  • Understanding the incidence and risk factors for HT is crucial for improving patient outcomes.
  • MZL encompasses various subtypes, including extranodal (MALT lymphoma), splenic (SMZL), and nodal (NMZL), as well as clonal B-cell lymphocytosis of marginal zone origin (CBL-MZ).

Purpose of the Study:

  • To analyze the incidence and risk factors associated with histologic transformation (HT) in a large cohort of marginal zone lymphoma (MZL) patients.
  • To determine the clinical characteristics and outcomes of patients who undergo HT.
  • To compare the risk of HT in MZL with that reported for other lymphoma subtypes.

Main Methods:

Keywords:
histologic transformationmarginal zone lymphomarisk factors

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  • A retrospective analysis of 340 MZL patients diagnosed and treated between 1995 and 2012.
  • Categorization of MZL subtypes: extranodal MZL (MALT lymphoma), splenic MZL (SMZL), nodal MZL (NMZL), and CBL-MZ.
  • Follow-up to assess incidence of HT, overall survival (OS), progression-free survival (PFS), and post-transformation survival.

    • Main Results:

    • The overall incidence of HT was 3.8% (13 cases) with a median follow-up of 4.8 years.
    • Elevated lactate dehydrogenase (LDH) at diagnosis was significantly associated with an increased risk of HT (P = 0.019).
    • The 5- and 10-year cumulative risk of HT was 5%, increasing to 10% at 12 years. Patients experiencing HT often presented with high LDH and B symptoms, and the 2-year post-transformation survival rate was 57%.

    Conclusions:

    • The risk of histologic transformation in marginal zone lymphoma appears to be lower than that reported for follicular lymphoma.
    • Elevated LDH at diagnosis is a key risk factor for HT in MZL.
    • HT in MZL is associated with significant morbidity and mortality, underscoring the need for vigilant monitoring.