large b cell lymphoma prognosis | MALT lymphoma

MALT lymphoma



The lymphoma of lymphoid tissue associated with the mucous membranes (MALT) of the Extraganglionnaire marginal zone is a B lymphocyte non-Hodgkin's lymphoma (NHL). It is said that the lymphoma of MALT is extraganglionnaire since it originates in tissues or organs located outside the lymph nodes. It appears in the lymphatic tissue of the mucous membranes or the tissue that is lining organs or cavities of the body.

The lymphoma of MALT is also called Matome. It almost affects both man and woman, usually in her sixties.

Most of the lymphomas of MALT originate in the stomach. More than 60% of people with stomach MALT lymphoma have a history of bacterial infection with Helicobacter pylori (H. pylori). Other bacterial and viral infections are also related to MALT lymphoma.

People with MALT lymphoma in other parts of the body that the stomach often have a history of autoimmune disorders such as Hashimoto's thyroid and the syndrome of the disease. These areas of the body include these:

Other parts of the digestive tract, such as the small intestine or the colon (longest segment of the large intestine)
Lungs
Fabric around the eye
Skin
Salivary glands
thyroid gland
Bladder
Breasts
In general, the lymphoma of MALT evolves slowly (indolent), but it happens that it develops rapidly (aggressive). It usually takes a long time to propagate outside the area where it originated, and is often diagnosed at stage 1 or 2. Although several extraganglionnaires seats are observed, this does not mean that lymphoma has spread throughout the body (generalized disease).

In rare cases, the lymphoma of MALT can turn into a rapidly evolving type of NHL that is aggressive.

Treatments
The lymphoma of the stomach malt is treated differently from the lymphoma of the malt that appears in another part of the body. Early-stage malt lymphoma is often treated differently from advanced-stage malt lymphoma.

Early stage stomach MALT lymphoma
The options for treatment of early stage MALT lymphoma (stage 1 or 2) that are confined to the stomach are as follows.

Antibiotics are often the first treatment if a biopsy confirms that you have an H. pylori infection.  Antibiotics may be the only treatment needed if a follow-up biopsy shows that the infection is missing and there is no sign of lymphoma.

Radiation therapy can be used if antibiotics are not effective. We run an external radiation therapy to the stomach tumors.

Chemotherapy is sometimes administered if the lymphoma of MALT does not react to antibiotics. A single drug, such as chlorambucil (Leukeran) or cyclophosphamide (Cytoxan, Procytox), can be used. Sometimes chemotherapy agents are associated with the CHOP protocol, which is based on cyclophosphamide, doxorubicin (Adriamycin), vincristine (Oncovin), and prednisone.

Targeted treatment uses drugs to target specific molecules (such as proteins) located on the surface of cancer cells. These molecules contribute to the sending of signals that tell cells to grow or divide. By targeting these molecules, medications interrupt the growth and spread of cancer cells while limiting damage to normal cells. Rituximab (Rituxan) is a targeted drug that can be administered if antibiotics are not effective or if MALT lymphoma evolves after chemotherapy.

Surgery is sometimes done to remove the stomach in part or in whole (partial or total gastrectomy) if the lymphoma has not disappeared after antibiotic treatment or if it evolves. Surgery is not as much practiced as before to treat stomach MALT lymphoma since other treatments are usually effective.

MALT lymphoma out of the early stage stomach
Early stage MALT lymphoma that originated in another region than the stomach can be treated locally, such as by surgery or radiotherapy.

Surgery to remove the area affected by lymphoma can be an option depending on its location in the body and its size.

An external radiation therapy can be administered to the affected area.

Advanced Stage MALT lymphoma

Advanced Stage MALT lymphoma (Stage 3 or 4) that is in the stomach or other part of the body may receive one of the following treatments.

Vigilant observation, also known as active surveillance, may be an option since the lymphoma of MALT develops slowly and may not need to be treated immediately. The care team carefully monitors the person with a MALT lymphoma and begins treatment when symptoms appear or if there are signs that the disease is evolving.

Radiation therapy can be used if the lymphoma is large, if it causes symptoms or if it gets bigger. An external radiation therapy is directed towards the tumor and a part of the tissue surrounding it.

Chemotherapy may be used instead of radiation if the lymphoma is large, if it grows, if there is cancer throughout the body (generalized disease) or if it reappears after being treated. The following medications or drug combinations may be administered:

Fludarabine (Fludara)

Bendamustine (Treanda)

Chlorambucil (Leukeran)

CHOP – Cyclophosphamide (Cytoxan, Procytox), doxorubicin (Adriamycin), vincristine (Oncovin), and prednisone protocol

CVP – cyclophosphamide, vincristine, and prednisone protocol

Targeted treatment can be administered if the stomach MALT lymphoma does not respond to antibiotics, if the lymphoma is not linked to an H. pylori infection or if it reappears (recurrence) after treatment. Rituximab (Rituxan) is a targeted drug that can be administered alone or associated with chemotherapy.