MALT lymphomas: pathogenesis can drive treatment.
Marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT) lymphoma is an indolent B-cell non-Hodgkin lymphoma arising from the lymphoid tissue at extranodal sites. It is genetically characterized by different, usually mutually exclusive, genetic abnormalities that lead to activation of the nuclear factor kappa B (NF-kappaB) pathway. These lymphomas can arise in any extranodal organ or tissue; however, the stomach--where MALT lymphoma development has been strongly linked to chronic Helicobacter pylori infection--is the most common site. Other microorganisms have been associated with non-gastric MALT lymphomas, but the evidence for such associations is weaker. Treatment aimed at eradicating H pylori infection results in remission of gastric MALT lymphoma in most patients and represents a model of anticancer treatment based on the eradication of the causative factor. Treatment of non-gastric MALT lymphomas is much less well established; either radiotherapy or systemic therapy (with chemotherapy and/or rituximab [Rituxan]) can be effective, while antibiotic therapies (e.g., doxycycline in ocular adnexal lymphomas) should still be considered investigational.
Lymphoma Unit and Institute of Oncology Research, Oncology Institute of Southern Switzerland (IOSI), Bellinzona, Switzerland.
Francesco
F
Bertoni
Bertrand
B
Coiffier
Gilles
G
Salles
Anastasios
A
Stathis
Alexandra
A
Traverse-Glehen
Catherine
C
Thieblemont
Emanuele
E
Zucca
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002869:Chromosome Aberrations; D016481:Helicobacter Infections / Q000150:complications / Q000188:drug therapy; D016480:Helicobacter pylori; D006801:Humans; D018442:Lymphoma, B-Cell, Marginal Zone / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology / Q000628:therapy*; D013274:Stomach Neoplasms / Q000209:etiology / Q000628:therapy; D015996:Survival Rate
D000900:Anti-Bacterial Agents