Therapy of gastric mucosa associated lymphoid tissue lymphoma

doi:10.3748/wjg.v13.i26.3554

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Gastroenterol. Jul 14, 2007; 13(26): 3554-3566
Published online Jul 14, 2007. doi: 10.3748/wjg.v13.i26.3554

Therapy of gastric mucosa associated lymphoid tissue lymphoma

Andrea Morgner, Renate Schmelz, Christian Thiede, Manfred Stolte, Stephan Miehlke

Andrea Morgner, Renate Schmelz, Christian Thiede, Stephan Miehlke, Medical DepartmentI, University Hospital, Technical University Dresden, Germany

Manfred Stolte, Institute for Pathology, Academic Teaching Hospital Bayreuth, Bayreuth, Germany

Author contributions: All authors contributed equally to the work.

Correspondence to: Andrea Morgner-Miehlke, MD, Associate Professor, Medical DepartmentI, Gastroenterology, University Hospital Carl Gustav Carus, Fetscherstrasse 74, Dresden 01307, Germany. andrea.morgner-miehlke@uniklinikum-dresden.de

Telephone: +49-351-4584194 Fax: +49-351-4584394

Received: April 2, 2007
Revised: April 3, 2007
Accepted: April 26, 2007
Published online: July 14, 2007

Abstract

Gastric mucosa associated lymphoid tissue (MALT) lymphoma has recently been incorporated into the World Health Organization (WHO) lymphoma classification, termed as extranodal marginal zone B-cell lymphoma of MALT-type. In about 90% of cases this lymphoma is associated with H pylori infection which has been clearly shown to play a causative role in lymphomagenesis. Although much knowledge has been gained in defining the clinical features, natural history, pathology, and molecular genetics of the disease in the last decade, the optimal treatment approach for gastric MALT lymphomas, especially locally advanced cases, is still evolving. In this review we focus on data for the therapeutic, stage dependent management of gastric MALT lymphoma. Hence, the role of eradication therapy, surgery, chemotherapy and radiotherapy is critically analyzed. Based on these data, we suggest a therapeutic algorithm that might help to better stratify patients for optimal treatment success.

Keywords: Gastric lymphoma; Mucosa-associated lymphoid tissue; H pylori; Eradication; Radiation; Surgery; Chemotherapy; Molecular genetics