Treatment Approaches for MALT Lymphoma Involving Monoclonal Antibodies Like Rituximab
MALT (mucosa-associated lymphoid tissue) lymphoma is a type of non-Hodgkin lymphoma that originates from B cells and develops in mucosal tissue. This form of cancer can affect various organs and sites throughout the body, such as the stomach, lungs, thyroid glands, salivary glands, and eye area tissue.
Rituximab, a monoclonal antibody medication, plays a significant role in the treatment of MALT lymphoma, particularly in systemic or advanced cases.
Rituximab works by marking cancer cells for the body's natural defense system to attack and eliminate. It targets a protein called CD20 that is found on the surface of B cells. The medication is usually given as an intravenous (IV) infusion, but can also be given as a quick injection under the skin.
For those whose lymphoma is localised and linked to a Helicobacter pylori infection, antibiotics alone may make the cancer go away completely. In such cases, rituximab may not be necessary immediately.
In early-stage or localized MALT lymphoma, especially gastric MALT lymphoma linked to Helicobacter pylori infection, antibiotic treatment targeting the infection can induce lymphoma regression without immediate need for immunotherapy or chemotherapy.
Rituximab is widely used for marginal zone lymphomas (including MALT lymphoma) either as a single agent or combined with chemotherapy agents like chlorambucil or bendamustine, showing convincing efficacy. It is often recommended particularly for symptomatic advanced-stage disease or relapsed cases.
In refractory or relapsed disease, combinations including rituximab plus lenalidomide or other targeted agents provide chemotherapy-free options and are under active clinical use and study. Case reports and small series show that rituximab treatment can also resolve lymphoma-associated symptoms such as acquired angioedema and induce substantial lymphoma remission.
Surgical intervention may be considered in some cases, often followed by radiotherapy, and is associated with long progression-free survival. However, systemic immunotherapy with agents like rituximab offers less invasive options.
While 540,000 patients worldwide have now received rituximab, side effects can include infusion-related reactions, increased risk of infections, increased rate of neutropenia when used in combination with chemotherapy, and rare side effects like progressive multifocal leukoencephalopathy.
For older patients, rituximab can be a safe and effective treatment, but their healthcare team will closely monitor them to make sure any risks are carefully managed during treatment. Notably, rituximab won't usually cause hair loss unlike some chemotherapy treatments.
In summary, rituximab is a cornerstone monoclonal antibody treatment for MALT lymphoma, especially in systemic cases or when chemotherapy is indicated, either alone or combined with other agents, and often preferred over more invasive options like splenectomy. For localized MALT lymphoma, initial strategies focus on infection eradication and/or radiation therapy, reserving rituximab for more advanced, symptomatic, or relapsed disease.
- In systemic or advanced cases of MALT lymphoma, the monoclonal antibody medication Rituximab plays a significant role, particularly marking cancer cells for the body's natural defense system to attack and eliminate.
- For those whose MALT lymphoma is localized and linked to a Helicobacter pylori infection, antibiotics alone may make the cancer go away completely, reducing the need for Rituximab.
- In early-stage or localized MALT lymphoma, especially gastric MALT lymphoma linked to a Helicobacter pylori infection, antibiotic treatment can induce lymphoma regression without immediate need for immunotherapy or chemotherapy like Rituximab.
- Rituximab is widely used in the treatment of marginal zone lymphomas (including MALT lymphoma) and is often recommended for symptomatic advanced-stage disease or relapsed cases.
- For older patients, Rituximab can be a safe and effective treatment, providing less invasive options compared to surgery or more invasive treatments like splenectomy in certain medical-conditions.
