Treatment outcome of mucosa associated lymphoid tissue (malt)‎ marginal zone non-hodgkin's lymphoma: single institutional experience

الملخص EN

Purpose : to evaluate the treatment outcome in patients with mucosa associated lymphoid tissue (MALT) lymphoma in terms of response to treatment, progression-free and overall survivals as well as prognostic factors.

Patients and Methods: Between 1995 and 2002, 40 patients with clinical stages (CS) I-IV MALT lymphoma were treated at NEMROCK.

The progression free survival (PFS) and overall survival (OAS) were calculated using the Kaplan Meier technique.

Thirty-one patients (77.5 %) had CS I-II and 9 (22.5 %) had CS III-IV disease.

Twenty of the 31 CS I-II patients received radiation therapy alone ; five patients received chemotherapy, while three patients were treated by triple therapy (Amoxicillin, Omeprazole, Clarithromycin).

Among the 9 CS III-IV patients, treatment included chemotherapy alone (6 patients), chemo radiation (2 patients) and surgery (one patient).

The median follow-up period was 40 months.

Results : 19 out of twenty patients with CS I-II treated by radiation therapy alone had a 95% response rate (CR 85 %-PR 10 %).

Among the study population (40 patients), the 5 year OAS and PFS were 86 % and 66 %, respectively.

The 5 year OAS was 86 % and PFS was 72 % among CS I-II patients; the corresponding estimates in CS III-IV patients were 70 % and 28 %, respectively.

Using multivariate analysis, there was a significant correlation between the stage of the disease, site of presentation (non GIT) and the overall survival.

Conclusion : modest doses of radiation therapy provide better local control in patients with early stage MALT lymphoma.

The poor PFS in advanced staged disease suggests the need for further clinical trials evaluating novel drug approaches taking into consideration the biological behavior and the indolent nature of such disease entity.