Radiation Oncology/NHL/MALT

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Front Page: Radiation Oncology | RTOG Trials | Randomized Trials

Non-Hodgkin lymphoma: Main Page | Randomized Overview: Overview | Follicular | Diffuse large B-cell | MALT (extranodal marginal zone) | Nodal marginal zone | Mantle cell | CLL/SLL | Lymphoblastic | Burkitt | NK/T cell | Anaplastic large cell | Primary CNS Lymphoma Treatment: Low grade and follicular | Diffuse and high grade | Marginal zone | Mantle cell | CLL/SLL | Lymphoblastic | Specific sites | Radioimmunotherapy

Contents 1 Overview 2 Work-Up 3 Reviews 4 Treatment 5 Gastric MALT 5.1 Helicobacter pylori eradication

[edit] Overview

• 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).

[edit] Work-Up

• 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

[edit] Reviews

• See also reviews at Nodal marginal zone lymphoma

[edit] Treatment

• See also Low grade 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

[edit] Gastric MALT

[edit] 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.