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Gastric Lymphoma: October 1995
Last modified on:
Tuesday, April 20, 1999 13:03:10
Copyright © 1994-2008, Information Ventures, Inc.
Gastric MALT Lymphoma -
The incidence and mortality rate for gastric cancer has been
declining for most of this century in Western countries, but
there is some evidence of an increasing incidence of the rare
gastric MALT lymphoma. This low-grade B-cell disease, may affect
the lung, small bowel, thyroid or salivary glands, but most often
occurs in the stomach. Recommended therapy for disease
apparently localized to the stomach is total gastrectomy, a
drastic procedure with significant morbidity and problems as
regards digestion and nutrition, which may not actually improve
the survival rate, and would not deal with distant relapses from
unsuspected metastases. A group from Henri Mondor Hospital in
Creteil, France, reporting in the October, 1995 issue of the Journal of
Clinical Oncology, describe the use of single agent chemotherapy
with cyclophosphamide (100 mg/day) or chlorambucil (6 mg/day) for
12 to 24 months in 24 patients, as an alternative to surgery.
Complete remissions occurred in 75% of patients after a median 12
months' treatment; five relapsed, of whom two were re-treated
successfully. One patient died after the disease converted to
large-cell lymphoma. The issue of whether gastric lymphoma, like
gastric cancer, is associated with Helicobacter pylori infections
was discussed by the authors. Wotherspoon has reported such a
connection, and regression of early MALT lymphoma after
eradication of the bacterial infection, in articles in Lancet
Volume 338: 1175, 1991, and Volume 342: 575, 1993. Others have
confirmed these findings. Eighty-four percent of the French
patients had Helicobacter infection. It would appear that
treatment of bacterial infection with antibiotics in early cases,
and with chemotherapy in those somewhat more advanced, should
obviate the need for recourse to surgery.
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