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MALT lymphoma: forget surgery?

Wolfgang Fischbach1

  • 1Medizinische Klinik II und Klinik für Palliativmedizin, Klinikum Aschaffenburg, Akademisches Lehrkrankenhaus der Universität Würzburg, Aschaffenburg, Germany. wolfgang.fischbach@klinikum-aschaffenburg.de

Digestive Diseases (Basel, Switzerland)
|June 26, 2013
PubMed
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[Watch-and-Wait and surveillance in gastric MALT-lymphoma after exclusive Helicobacter pylori eradication under special consideration of patients' compliance].

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Correction: From modern pathogenetic insights and molecular understanding to new deescalating therapeutic strategies in gastric MALT-lymphoma.

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From modern pathogenetic insights and molecular understanding to new deescalating therapeutic strategies in gastric MALT-lymphoma.

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Zeitschrift fur Gastroenterologie·2024

Treatment for gastric MALT lymphoma begins with Helicobacter pylori eradication, achieving remission in 70-80% of patients. Non-responders or advanced stages may require radiation or chemotherapy.

Area of Science:

  • Gastroenterology
  • Oncology
  • Hematology

Background:

  • Gastric marginal zone B cell lymphoma of MALT (mucosa-associated lymphoid tissue) treatment is guided by established German and European consensus reports.
  • Helicobacter pylori (H. pylori) infection is a primary factor in gastric MALT lymphoma development.

Purpose of the Study:

  • To outline current standardized treatment strategies for gastric MALT lymphoma.
  • To discuss management approaches for non-responders and advanced stages of the disease.
  • To address the treatment of diffuse large B cell lymphoma (DLBCL) of the stomach.

Main Methods:

  • Review of German S3 guideline (2009) and European (EGILS) consensus report (2011).
  • Focus on H. pylori eradication as the first-line therapy for gastric MALT lymphoma.

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  • Description of subsequent treatment modalities including radiation, chemotherapy, and watchful waiting.
  • Main Results:

    • Successful H. pylori eradication leads to complete remission in 70-80% of gastric MALT lymphoma patients.
    • Non-responders to eradication therapy are treated with radiation (stages I-II) or chemotherapy (stages III-IV).
    • Immunochemotherapy with rituximab and CHOP protocol is the standard for gastric DLBCL, offering good curative potential.

    Conclusions:

    • H. pylori eradication is the primary treatment for gastric MALT lymphoma.
    • Treatment selection for gastric MALT lymphoma depends on H. pylori status, lymphoma stage, and response to initial therapy.
    • Gastric DLBCL is managed with immunochemotherapy, with H. pylori eradication as a potential adjunctive measure.