Mucosa-associated lymphoid tissue lymphoma: a perspective on current and future therapeutic strategies

Abstract

Introduction: Helicobacter pylori-eradication is the defined standard care for patients with H. pylori-associated gastric mucosa-associated lymphoid tissue (MALT) lymphoma. However, to date there is no clearly defined consensus on treatment of eradication-refractory, relapsed or extragastric MALT lymphoma.

Areas covered: The authors have conducted a computerized search in MEDLINE to identify recent publications of relevance for current treatment options of MALT lymphoma patients with a special focus on systemic treatment strategies. Therapeutic strategies covered in this article include antibacterial treatment beyond H. pylori-eradication, that is, doxycycline and clarithromycin for orbital MALT lymphoma, respectively; anti-CD20-antibody monotherapy with rituximab (R) for gastric and extragastric patients; further immunomodulatory approaches for example, lenalidomide and everolimus; and finally new data on chemotherapy-containing treatments plus/minus R (chlorambucil ± R, cladribine ± R, bendamustine + R). The aim of this article is to provide the reader with a concise overview with implications for daily practice.

Expert opinion: Recently, systemic treatment strategies have been increasingly applied in MALT lymphoma and particularly regimens with a favorable toxicity profile are of interest. Beside chemotherapies with or without R, immunomodulatory substances and antibiotics beyond H. pylori-eradication are also being tested. In conclusion, systemic treatment appears to be safe and feasible not only for systemic but also for localized disease.

Keywords:

• bendamustine
• clarithromycin
• chlorambucil
• doxycycline
• extranodal lymphoma
• lenalidomide
• mucosa-associated lymphoid tissue lymphoma

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Notes

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