title: Antibiotic therapy in nongastrointestinal MALT lymphoma: a review of the literature.
abstract: Although antibiotic therapy has been established as the standard of care in patients with gastric mucosa-associated lymphoid tissue (MALT) lymphoma, much less is known about the value of antibiotic therapy in nongastrointestinal (non-GI) MALT lymphomas. A computerized search (Medline) accompanied by a manual search to identify clinical reports on the topic of antibacterial therapy in patients with non-GI MALT lymphomas was performed. The majority of data were available for MALT lymphoma of the ocular adnexa (OAML) including a total of 131 patients in 4 retrospective studies, 3 prospective series (including 81 patients), and 1 case report. Treatment was exclusively targeting Chlamydophila psittaci (CP), using doxycycline in all but 2 studies. The median follow-up for these studies was 25 months, and both CP-positive as well as CP-negative patients responded. Complete remission was achieved in 23 patients (18%), 36 (27%) had a partial remission, 55 (42%) had stable disease, and 8 patients (6%) had progressive disease accounting for an overall response rate of 45%. In the largest study, a better response was suggested in CP-positive patients. By contrast, only scattered reports could be found for other non-GI localizations, allowing no conclusion about the benefit of antibiotic therapy and probably resulting in a publication bias toward positive cases. Based on these results, antibiotic therapy using doxycycline appears to be a reasonable first-line therapy for patients with OAML. Antibiotics, however, remain experimental for the time being in patients with other non-GI MALT lymphomas. Further preclinical studies as well as large-scale therapeutic trials are warranted to define the role of antibiotic therapy in such patients.
authors.affiliation: Division of Oncology, Department of Internal Medicine I, Medical University Vienna, Waehringer Guertel 18–20,Vienna, Austria.
authors.forename: Barbara
authors.initials: B
authors.lastname: Kiesewetter
authors.forename: Markus
authors.initials: M
authors.lastname: Raderer
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D023521:Chlamydophila Infections / Q000150:complications / Q000188:drug therapy; D002691:Chlamydophila psittaci; D002986:Clinical Trials as Topic; D018450:Disease Progression; D004318:Doxycycline / Q000627:therapeutic use; D005134:Eye Neoplasms / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D018442:Lymphoma, B-Cell, Marginal Zone / Q000150:complications / Q000188:drug therapy*; D012074:Remission Induction; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D004318:Doxycycline