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MALT Lymphomas.

F Cavalli1, P G Isaacson, R D Gascoyne

  • 1Oncology Institute of Southern Switzerland, Department of Medical Oncology.

Hematology. American Society of Hematology. Education Program
|November 28, 2001
PubMed
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This review details mucosa-associated lymphoid tissue (MALT) lymphomas, a subtype of extranodal marginal zone lymphomas (MZL). It covers their biology, diagnosis, and treatment, highlighting unique properties and challenges in managing gastric MALT lymphoma.

Area of Science:

  • Hematology
  • Oncology
  • Pathology

Background:

  • Mucosa-associated lymphoid tissue (MALT) lymphomas represent approximately 8% of non-Hodgkin's lymphomas.
  • Recently re-classified as extranodal marginal zone lymphomas of MALT-type, they are a significant subtype of marginal zone lymphomas (MZL).
  • Gastric MALT lymphoma is the most common and extensively studied variant, serving as a paradigm for the group.

Purpose of the Study:

  • To review the biology, histology, and treatment of MALT lymphomas.
  • To differentiate MALT lymphomas from other small B-cell lymphomas.
  • To explore the pathogenesis, including the role of H. pylori and genetic factors, and compare treatment strategies for gastric and non-gastric MALT lymphomas.

Main Methods:

  • Review of histological features and diagnostic criteria for MALT lymphomas.

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  • Analysis of evidence linking gastric MALT lymphoma to H. pylori infection.
  • Examination of cytogenetic and molecular genetic findings, including translocations and gene expression (e.g., bcl10).
  • Comparison of clinical behaviors and treatment outcomes based on data from the International Extranodal Lymphoma Study Group (ILESG).

    • Main Results:

    • MALT lymphomas are composed of mature B-cells (CD5-, CD10-) with distinct clinical behaviors despite overlapping morphology.
    • H. pylori eradication is a key treatment for gastric MALT lymphoma, but approximately one-third of cases are refractory.
    • Specific genetic alterations, such as t(11;18) and bcl10 nuclear expression, are associated with treatment resistance to H. pylori eradication.
    • Unique biological properties characterize MALT lymphomas across various extranodal sites.

    Conclusions:

    • MALT lymphomas exhibit unique biological characteristics influencing their pathogenesis and clinical presentation.
    • Understanding genetic factors is crucial for predicting treatment response, particularly for gastric MALT lymphoma.
    • Further research is needed to refine treatment guidelines for the diverse spectrum of MALT lymphomas.