State-of-the-art therapeutics: Marginal-zone lymphoma

被引:79
作者
Bertoni, F
Zucca, E
机构
[1] Oncol Inst So Switzerland, Expt Oncol Lab, Bellinzona, Switzerland
[2] Oncol Inst So Switzerland, Lymphoma Unit, Bellinzona, Switzerland
关键词
D O I
10.1200/JCO.2005.05.018
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Marginal-zone lymphomas comprise the mucosa-associated lymphoid tissue (MALT) type (extranodal marginal-zone lymphoma [EMZL]), the nodal marginal zone B-cell lymphoma (NMZL) and the splenic MZL (SMZL). EMZL is relatively common, whereas the remaining two entities are relatively rare disorders. EMZL, especially in its gastric localization, is the most studied MZL, and there are many data both on the underlying genetic lesions and on the role of infectious agents. These data have determined unique approach among all other lymphoma subtypes: the possibility of treating a subset of patients with antibiotics alone as first line of treatment. Indeed, there is compelling evidence that histologic regressions can be achieved in most gastric MALT lymphomas by eradicating Helicobacter pylori infection. However, molecular follow-up studies showed the persistence of the malignant clone in half of the cases in histologic remission after antibiotic treatment and transient, either histologic or molecular, relapses have been reported, too. Hence, a careful long-term follow-up is mandatory after antibiotic treatment, Radiotherapy, chemotherapy, anti-CD20 monoclonal antibodies are effective alternative therapies. The precise role of surgical resection should be redefined in view of the encouraging results of conservative approaches. Differently from EMZL, both SMLZ and NMZL often present with disseminated disease at diagnosis. The therapeutic approach comprises splenectomy, for SMZL, and chemotherapy, but with no consensus about the best treatment. This review addresses the current knowledge on the clinical features and therapeutic approaches for the individual MZLs.
引用
收藏
页码:6415 / 6420
页数:6
相关论文
共 81 条
[61]   Variable frequencies of MALT lymphoma-associated genetic aberrations in MALT lymphomas of different sites [J].
Streubel, B ;
Simonitsch-Klupp, I ;
Müllauer, L ;
Lamprecht, A ;
Huber, D ;
Siebert, R ;
Stolte, M ;
Trautinger, F ;
Lukas, J ;
Püspök, A ;
Formanek, M ;
Assanasen, T ;
Müller-Hermelink, HK ;
Cerroni, L ;
Raderer, M ;
Chott, A .
LEUKEMIA, 2004, 18 (10) :1722-1726
[62]   T(14;18)(q32;q21) involving IGH and MALT1 is a frequent chromosomal aberration in MALT lymphoma [J].
Streubel, B ;
Lamprecht, A ;
Dierlamm, J ;
Cerroni, L ;
Stolte, M ;
Ott, G ;
Raderer, M ;
Chott, A .
BLOOD, 2003, 101 (06) :2335-2339
[63]  
Thieblemont C, 2004, MED INTELL UNIT, P60
[64]  
Thieblemont C, 2003, LANCET ONCOL, V4, P95, DOI 10.1016/S1470-2045(03)00981-1
[65]   Small lymphocytic lymphoma, marginal zone B-cell lymphoma, and mantle cell lymphoma exhibit distinct gene-expression profiles allowing molecular diagnosis [J].
Thieblemont, C ;
Nasser, V ;
Felman, P ;
Leroy, K ;
Gazzo, S ;
Callet-Bauchu, E ;
Loriod, B ;
Granjeaud, S ;
Gaulard, P ;
Haioun, C ;
Traverse-Glehen, A ;
Baseggio, L ;
Bertucci, F ;
Birnbaum, D ;
Magrangeas, F ;
Minvielle, S ;
Avet-Loiseau, H ;
Salles, G ;
Coiffier, B ;
Berger, F ;
Houlgatte, R .
BLOOD, 2004, 103 (07) :2727-2737
[66]   Treatment of splenic marginal zone B-cell lymphoma: An analysis of 81 patients [J].
Thieblemont, C ;
Felman, P ;
Berger, F ;
Dumontet, C ;
Arnaud, P ;
Hequet, O ;
Arcache, J ;
Callet-Bauchu, E ;
Salles, G ;
Coiffier, B .
CLINICAL LYMPHOMA, 2002, 3 (01) :41-47
[67]   Outcome in relation to treatment modalities in 48 patients with localized gastric MALT lymphoma: A retrospective study of patients treated during 1976-2001 [J].
Thieblemont, C ;
Dumontet, C ;
Bouafia, F ;
Hequet, O ;
Arnaud, P ;
Espinouse, D ;
Felman, P ;
Berger, F ;
Salles, G ;
Coiffier, B .
LEUKEMIA & LYMPHOMA, 2003, 44 (02) :257-262
[68]  
THIEBLEMONT C, 1999, ANN ONCOL, V10, P25
[69]   Long-term persistence of monoclonal B cells after cure of Helicobacter pylori infection and complete histologic remission in gastric mucosa-associated lymphoid tissue B-cell lymphoma [J].
Thiede, C ;
Wündisch, T ;
Alpen, B ;
Neubauer, B ;
Morgner, A ;
Schmitz, M ;
Ehninger, G ;
Stolte, M ;
Bayerdörffer, E ;
Neubauer, A .
JOURNAL OF CLINICAL ONCOLOGY, 2001, 19 (06) :1600-1609
[70]   Splenic lymphoma with villous lymphocytes: Clinical presentation, biology and prognostic factors in a series of 100 patients [J].
Troussard, X ;
Valensi, F ;
Duchayne, E ;
Garand, R ;
Felman, P ;
Tulliez, M ;
HenryAmar, M ;
Bryon, PA ;
Flandrin, G .
BRITISH JOURNAL OF HAEMATOLOGY, 1996, 93 (03) :731-736