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MALT Lymphomas.

Sami N Malek1, Amy J Hatfield, Ian W Flinn

  • 1The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, 1650 Orleans Street, CRB Room 388, Baltimore, MD 21231, USA.

Current Treatment Options in Oncology
|August 29, 2003
PubMed
Summary
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Mucosa-associated lymphoid tissue (MALT) lymphomas are indolent tumors often localized to various organs. Treatment for these MALT lymphomas is tailored to the specific organ and stage, with Helicobacter pylori eradication being key for gastric MALT lymphomas.

Area of Science:

  • Oncology
  • Hematology
  • Pathology

Background:

  • Mucosa-associated lymphoid tissue (MALT) lymphomas are a group of indolent neoplasms.
  • These lymphomas can arise in various extranodal sites, including the orbit, conjunctiva, salivary glands, skin, thyroid, lungs, stomach, and intestine.
  • They are typically characterized by localized disease and a slow clinical progression.

Purpose of the Study:

  • To provide a comprehensive overview of the diagnosis, staging, and treatment strategies for MALT lymphomas.
  • To highlight the organ-specific management approaches for MALT lymphomas.
  • To discuss the evolving role of surgery and the standard of care for different stages and subtypes of MALT lymphomas.

Main Methods:

  • Diagnosis relies on pathologic evaluation of tissue biopsies.

Related Experiment Videos

  • Staging involves a thorough history and physical examination, laboratory tests, imaging (CT scans), bone marrow biopsy, and specialized consultations (ENT, endoscopy).
  • Tumor analysis includes cytogenetic and immunohistochemical assessments.
  • Main Results:

    • Helicobacter pylori eradication is the standard treatment for H. pylori-positive gastric MALT lymphomas, achieving high response rates (60-90%) for early-stage disease.
    • Localized MALT lymphomas in organs like the orbit, conjunctiva, salivary glands, and thyroid are successfully treated with radiotherapy.
    • Advanced or refractory disease may require radiotherapy, surgery, or chemotherapy (e.g., CHOP regimen for high-grade components).

    Conclusions:

    • Treatment for MALT lymphomas must be individualized based on organ involvement, disease stage, and tumor characteristics.
    • While H. pylori eradication is highly effective for gastric MALT lymphomas, other therapeutic modalities like radiotherapy, surgery, and chemotherapy remain crucial for specific presentations.
    • Disseminated MALT lymphomas are generally incurable and managed palliatively with chemotherapy.