title: Treatment of gastric marginal zone B-cell lymphoma of the mucosa-associated lymphoid tissue with rituximab, cyclophosphamide, vincristine and prednisone.
abstract: There is no standard treatment for patients with gastric marginal zone B-cell lymphoma of the mucosa-associated lymphoid tissue (MALT lymphoma) who are resistant to, or ineligible for, anti-Helicobacter pylori (anti-HP) therapy. In this study, we investigated the activity of the rituximab, cyclophosphamide, vincristine and prednisone (R-CVP) regimen in patients with gastric MALT lymphoma. Patients were included provided they had untreated gastric MALT lymphoma (except for anti-HP therapy) and were resistant to, or ineligible for, anti-HP therapy. Treatment plan consisted of six to eight 21-day cycles of the R-CVP chemotherapy regimen. Toxicity, response, relapse and survival were evaluated. Twenty patients (12 women and 8 men) were included in the analyses with median age of 59 years. Thirteen patients (65%) had stage I tumours, and seven patients (35%) had stages II-IV tumours. The overall response rate was 100%, with 19 (95%) complete responses and one (5%) partial response. Regimen toxicity was mild and mainly hematological, and no cases of gastric bleeding or perforation occurred. After a median follow-up of 56.3 months, three patients had relapsed, and 19 patients remained alive (specific lymphoma survival 100%), of whom 17 had no evidence of disease. In our experience, the R-CVP regimen is a well-tolerated and effective treatment for patients with gastric MALT lymphoma who are resistant to, or ineligible for, anti-HP therapy.
authors.affiliation: Department of Medical Oncology, Hospital Universitario de Gran Canaria Dr Negrin, Las Palmas de Gran Canaria, Spain.
authors.forename: David
authors.initials: D
authors.lastname: Aguiar-Bujanda
authors.forename: Ignacio
authors.initials: I
authors.lastname: Llorca-Mártinez
authors.forename: José C
authors.initials: JC
authors.lastname: Rivero-Vera
authors.forename: María J
authors.initials: MJ
authors.lastname: Blanco-Sánchez
authors.forename: Pedro
authors.initials: P
authors.lastname: Jiménez-Gallego
authors.forename: Marta
authors.initials: M
authors.lastname: Mori-De Santiago
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Limeres-Gonzalez
authors.forename: José C
authors.initials: JC
authors.lastname: Cabrera-Marrero
authors.forename: María
authors.initials: M
authors.lastname: Hernández-Sosa
authors.forename: Saray
authors.initials: S
authors.lastname: Galván-Ruíz
authors.forename: Samuel
authors.initials: S
authors.lastname: Hernández-Sarmiento
authors.forename: Salvador
authors.initials: S
authors.lastname: Saura Grau
authors.forename: Uriel
authors.initials: U
authors.lastname: Bohn-Sarmiento
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D058846:Antibodies, Monoclonal, Murine-Derived / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003520:Cyclophosphamide / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D018442:Lymphoma, B-Cell, Marginal Zone / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011241:Prednisone / Q000008:administration & dosage; D012189:Retrospective Studies; D000069283:Rituximab; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D016896:Treatment Outcome; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D000069283:Rituximab; D014750:Vincristine; D003520:Cyclophosphamide; D011241:Prednisone
keywords: Helicobacter pylori; MALT lymphoma; extranodal lymphoma; gastric lymphoma; marginal zone B-cell lymphoma of the mucosa-associated lymphoid tissue; rituximab