Epidemiological and clinical aspects of malt lymphomas

Abstract

Background. Marginal zone B-cell lymphoma (MALT) is an indolent lymphoma often found in the stomach (35%), linked to infections (H. pylori, C. jejuni) or autoimmune diseases. It peaks in the 7th–8th decades of life, with slight female predominance. Rising H. pylorinegative cases require new treatments. Objective(s). Evaluation of etiopathogenic correlations, diagnostic methods, and treatment efficacy for MALT lymphomas, focusing on antibacterial eradication and strategies for refractory cases. Materials and methods. A retrospective analysis of 62 studies from PubMed/Scopus (2015–2023) was conducted, focusing on gastrointestinal MALT lymphomas with data on etiology, treatment, and response. Correlations between infectious agents and treatment response were analyzed using logistic regression, and geographic differences were assessed by the Student’s t-test. Results. The response rate to Helicobacter pylori eradication in gastric MALT lymphoma was 78.2% (n=1120 patients). For H. pylori-negative MALT lymphomas, radiotherapy achieved a response rate of 85.3% (n=134 patients). Transformation into diffuse large B-cell lymphoma (DLBCL) occurred in 2.1% of cases. The correlation with Campylobacter jejuni in intestinal MALT showed an antibiotic response rate of 89% (n=45). Geographic differences in etiology were significant (p<0.05), indicating variability of infectious factors across regions. These results support the importance of personalized therapy adapted to patient characteristics. Conclusion(s). Eradication therapy remains the main treatment for H. pylori-positive gastric MALT lymphoma. H. pylori-negative cases require radiotherapy or rituximab. Geographic links to infectious agents show the need for personalized approaches. The efficacy hypothesis of antibiotic treatments is confirmed.