Non-Hodgkin lymphoma: Main Page | Randomized
- MALT is classified as an extra-nodal marginal zone lymphoma.
- Extra-nodal marginal zone lymphomas tend to home to a certain tissue and remain localized. Therefore, MALT lymphomas are often stage I and highly curable.
- Pathologically, see lymphoepithelial lesions as the malignant lymphoma cells invade and destroy normal epithelium (such as glands).
- Tel Aviv, 2007 (Israel) PMID 17662066 -- "Diagnostic accuracy of PET/CT in patients with extranodal marginal zone MALT lymphoma." (Perry C, Eur J Haematol. 2007 Sept 79(3), 205-209)
- Prospective. 33 patients with bx-proven MALT lymphoma, evaluated with PET/CT. Sites: gastric 55%, lung 15%, orbit 12%, parotid 9%
- PET/CT: Active disease at diagnosis 55%. Sensitivity gastric 39% vs. non-gastric 75%. Advanced disease 100% vs. early stage (I-II) 42%
- Conclusion: PET/CT useful tool; sensitivity depends on stage and location
- See also reviews at Nodal marginal zone lymphoma
- See also Follicular lymphoma treatment page
- JAROG; 2007 (Japan)(2002-2004) PMID 17601683 -- "A Multicenter Phase II Study of Local Radiation Therapy for Stage IEA Mucosa-Associated Lymphoid Tissue Lymphomas: A Preliminary Report From the Japan Radiation Oncology Group (JAROG)." (Isobe K, Int J Radiat Oncol Biol Phys. 2007 Nov 15;69(4):1181-6. Epub 2007 Jul 2.)
- Phase II. 37 patients with MALT (orbit n=24, thyroid n=4, salivary n=4, others n=5). RT dose: if orbital or minimal residual disease 30.6 Gy, if residual tumor <6cm 36 Gy, if >6 cm 39.6 Gy. Median F/U 3.1 years
- Outcome: 3-year OS 100%, PFS 92%, LC 97%
- Toxicity: Late Grade 3 (cataract) 3 patients
- Conclusion: Moderate RT dose highly effective
Helicobacter pylori eradication
- Germany, 2005 - PMID 16204012 — "Long-Term Follow-Up of Gastric MALT Lymphoma After Helicobacter Pylori Eradication." Wündisch T et al. J Clin Oncol. 2005 Nov 1;23(31):8018-24.
- 120 pts. Stage IE. Median f/u 75 mo.
- 5-yr OS 90%. 80% achieved CR by biopsy. 80% of CR pts remained in CR; 17% showed histologic residual dz during follow-entered a second CR; 3% of those with CR had a relapse.
- Memorial Sloan Kettering; 1998 - PMID 9586910 — "Treatment of mucosa-associated lymphoid tissue lymphoma of the stomach with radiation alone." (Schechter N, J Clin Oncol. 1998 May;16(5):1916-21.)
- Retrospective. 17 patients with stage 1-2 low-grade MALT of the stomach. RT alone to median 30 Gy (range, 28.5 to 43.5 Gy) in 1.5 Gy fractions within 4 weeks to stomach and adjacent lymph nodes. Median F/U 27 mo.
- Outcome: 100% biopsy-confirmed CR. 100% EFS at last F/U
- Toxicity: No significant side effects
- Conclusion: Low-dose RT alone is feasible and safe
Chlamydophila Psittaci eradication
- Extrandoal Lymphoma Study Group; 2012 PMID 22802315 -- "Chlamydophila Psittaci Eradication With Doxycycline As First-Line Targeted Therapy for Ocular Adnexae Lymphoma: Final Results of an International Phase II Trial." (Ferreri AJ, J Clin Oncol. 2012 Aug 20;30(24):2988-94. Epub 2012 Jul 16.)
- Phase II. 47 patients with ocular adnexal marginal zone lymphoma (OAMZL). Assessment of Chlamydophila psittaci (Cp), followed by treatment with doxycyline. Median F/U 3.1 years
- Outcome: Cp DNA detected in 89% of biopsies. Lymphoma regression in 65%. 5-year PFS 55%. Cp eradiaction associated with improved response (SS) and PFS (NS)
- Conclusion: Upfront doxycycline is a rational and active treatment for patients with Stage I Cp-positive OAMZL