马尔特淋巴瘤
幽门螺杆菌
淋巴瘤
粘膜相关淋巴组织
医学
边缘地带
胃淋巴瘤
美罗华
边缘区B细胞淋巴瘤
免疫学
抗生素
淋巴系统
胃肠病学
内科学
病理
B细胞
生物
抗体
微生物学
作者
Emanuele Zucca,Francesco Bertoni
出处
期刊:Blood
[American Society of Hematology]
日期:2016-03-18
卷期号:127 (17): 2082-2092
被引量:239
标识
DOI:10.1182/blood-2015-12-624304
摘要
Abstract Extranodal marginal zone (MZ) B-cell lymphomas of the mucosa-associated lymphoid tissue (MALT) arise from lymphoid populations that are induced by chronic inflammation in extranodal sites. The best evidence of an etiopathogenetic link is provided by the association between Helicobacter pylori–positive gastritis and gastric MALT lymphoma. Indeed, successful eradication of this microorganism with antibiotics can be followed by gastric MALT lymphoma regression in most cases. Other microbial agents have been implicated in the pathogenesis of MZ lymphoma arising at different sites. Apart from gastric MALT lymphoma, antibiotic therapies have been adequately tested only in ocular adnexal MALT lymphomas where upfront doxycycline may be a reasonable and effective initial treatment of patients with Chlamydophila psittaci–positive lymphoma before considering more aggressive strategies. In all other instances, antibiotic treatment of nongastric lymphomas remains investigational. Indeed, there is no clear consensus for the treatment of patients with gastric MALT lymphoma requiring further treatment beyond H pylori eradication or with extensive disease. Both radiotherapy and systemic treatments with chemotherapy and anti-CD20 antibodies are efficacious and thus the experience of individual centers and each patient’s preferences in terms of adverse effects are important parameters in the decision process.
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