Marginal zone lymphoma
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21 regimens on this page
22 variants on this page
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Guidelines
ESMO
- 2013: ESMO Consensus conferences: guidelines on malignant lymphoma. part 2: marginal zone lymphoma, mantle cell lymphoma, peripheral T-cell lymphoma PubMed
- 2013: Gastric marginal zone lymphoma of MALT type: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up PubMed
Older
- 2009: Gastric marginal zone lymphoma of MALT type: ESMO Clinical Recommendations for diagnosis, treatment and follow-up PubMed
NCCN
First-line therapy, randomized data
Note: This implies chemotherapy-naive. Some patients in the following studies, especially those with gastric MALT, received H. pylori eradication therapy or radiation prior to chemotherapy.
BR
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BR: Bendamustine, Rituximab
Regimen
Study | Evidence | Comparator | Efficacy |
---|---|---|---|
Flinn et al. 2014 (BRIGHT) | Phase III | R-CHOP R-CVP |
Superior PFS (*) |
Salar et al. 2014 (GELTAMO MALT2008-01) | Phase II |
Efficacy for BRIGHT is based on the 2017 update.
Chemotherapy
Note: the bendamustine infusion instructions are for the Treanda formulation, which was discontinued on 3/31/2016.
- Bendamustine 90 mg/m2 IV over 30 minutes once on days 1 & 2
- Rituximab (Rituxan) 375 mg/m2 IV once on day 1
Supportive medications
- Antiemetics, antipyretics, and antibiotics according to local standard of care
- Prophylactic use of G-CSF allowed according ASCO guidelines (2006)
28-day cycle for up to 8 cycles, see note
Note: treatment in MALT2008-01 was response adapted; patients with CR after 3 cycles received a total of 4 cycles, whereas patients with PR after 3 cycles received a total of 6 cycles.
References
- Flinn IW, van der Jagt R, Kahl BS, Wood P, Hawkins TE, Macdonald D, Hertzberg M, Kwan YL, Simpson D, Craig M, Kolibaba K, Issa S, Clementi R, Hallman DM, Munteanu M, Chen L, Burke JM. Randomized trial of bendamustine-rituximab or R-CHOP/R-CVP in first-line treatment of indolent NHL or MCL: the BRIGHT study. Blood. 2014 May 8;123(19):2944-52. Epub 2014 Mar 3. link to original article contains verified protocol link to PMC article PubMed
- Update: Abstract: Ian Flinn, Richard van der Jagt, Julie E. Chang, Peter Wood, Tim E. Hawkins, David MacDonald, Judith Trotman, David Simpson, Kathryn S. Kolibaba, Samar Issa, Doreen M. Hallman, Ling Chen, and John M. Burke. First-line treatment of iNHL or MCL patients with BR or R-CHOP/R-CVP: Results of the BRIGHT 5-year follow-up study. Journal of Clinical Oncology 2017 35:15_suppl, 7500-7500 link to abstract
- Salar A, Domingo-Domenech E, Panizo C, Nicolás C, Bargay J, Muntañola A, Canales M, Bello JL, Sancho JM, Tomás JF, Rodríguez MJ, Peñalver FJ, Grande C, Sánchez-Blanco JJ, Palomera L, Arranz R, Conde E, García M, García JF, Caballero D, Montalbán C; Grupo Español de Linfomas/Trasplante de Médula Ósea (GELTAMO). First-line response-adapted treatment with the combination of bendamustine and rituximab in patients with mucosa-associated lymphoid tissue lymphoma (MALT2008-01): a multicentre, single-arm, phase 2 trial. Lancet Haematol. 2014 Dec;1(3):e104-11. Epub 2014 Nov 19. link to original article contains protocol PubMed
- Update: Salar A, Domingo-Domenech E, Panizo C, Nicolás C, Bargay J, Muntañola A, Canales M, Bello JL, Sancho JM, Tomás JF, Rodríguez MJ, Peñalver J, Grande C, Sánchez-Blanco JJ, Palomera L, Arranz R, Conde E, García M, García JF, Caballero D, Montalbán C. Long-term results of a phase 2 study of rituximab and bendamustine for mucosa-associated lymphoid tissue lymphoma. Blood. 2017 Oct 12;130(15):1772-1774. Epub 2017 Aug 11. link to original article PubMed
Chlorambucil monotherapy
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Regimen #1
Study | Evidence | Comparator | Efficacy |
---|---|---|---|
Leblond et al. 2012 (WM1) | Phase III | Fludarabine | Seems to have inferior OS |
Chemotherapy
- Chlorambucil (Leukeran) 8 mg/m2 (6 mg/m2 per day if older than 75 years old) PO once per day on days 1 to 10
Supportive medications
- Recommended PCP prophylaxis with ONE of the following:
- Trimethoprim/Sulfamethoxazole (Bactrim SS) 1 tablet PO once per day
- Pentamidine (Nebupent) 300 mg inhaled once per month
28-day cycle for up to 12 cycles
Regimen #2
Study | Evidence | Comparator | Efficacy |
---|---|---|---|
Zucca et al. 2013 (IELSG-19) | Phase III | Chlorambucil & Rituximab | Seems to have inferior PFS (*) |
Rituximab | Seems not superior (*) |
Note: reported efficacy is based on the 2017 update.
Chemotherapy
- Chlorambucil (Leukeran) 6 mg/m2 PO once per day on days 1 to 42
One course
Patients with stable disease or better proceeded to chlorambucil consolidation.
References
- Leblond V, Johnson S, Chevret S, Copplestone A, Rule S, Tournilhac O, Seymour JF, Patmore RD, Wright D, Morel P, Dilhuydy MS, Willoughby S, Dartigeas C, Malphettes M, Royer B, Ewings M, Pratt G, Lejeune J, Nguyen-Khac F, Choquet S, Owen RG. Results of a randomized trial of chlorambucil versus fludarabine for patients with untreated waldenstrom macroglobulinemia, marginal zone lymphoma, or lymphoplasmacytic lymphoma. J Clin Oncol. 2013 Jan 20;31(3):301-7. Epub 2012 Dec 10. link to original article contains verified protocol PubMed
- Zucca E, Conconi A, Laszlo D, López-Guillermo A, Bouabdallah R, Coiffier B, Sebban C, Jardin F, Vitolo U, Morschhauser F, Pileri SA, Copie-Bergman C, Campo E, Jack A, Floriani I, Johnson P, Martelli M, Cavalli F, Martinelli G, Thieblemont C. Addition of rituximab to chlorambucil produces superior event-free survival in the treatment of patients with extranodal marginal-zone B-cell lymphoma: 5-year analysis of the IELSG-19 randomized study. J Clin Oncol. 2013 Feb 10;31(5):565-72. Epub 2013 Jan 7. link to original article contains verified protocol PubMed
- Update: Zucca E, Conconi A, Martinelli G, Bouabdallah R, Tucci A, Vitolo U, Martelli M, Pettengell R, Salles G, Sebban C, Guillermo AL, Pinotti G, Devizzi L, Morschhauser F, Tilly H, Torri V, Hohaus S, Ferreri AJM, Zachée P, Bosly A, Haioun C, Stelitano C, Bellei M, Ponzoni M, Moreau A, Jack A, Campo E, Mazzucchelli L, Cavalli F, Johnson P, Thieblemont C. Final results of the IELSG-19 randomized trial of mucosa-associated lymphoid tissue lymphoma: improved event-free and progression-free survival with rituximab plus chlorambucil versus either chlorambucil or rituximab monotherapy. J Clin Oncol. 2017 Jun 10;35(17):1905-1912. Epub 2017 Mar 29. link to original articlePubMed
Chlorambucil & Rituximab
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Regimen
Study | Evidence | Comparator | Efficacy |
---|---|---|---|
Zucca et al. 2013 (IELSG-19) | Phase III | Chlorambucil Rituximab |
Seems to have superior PFS (*) |
Note: reported efficacy is based on the 2017 update.
Chemotherapy
- Chlorambucil (Leukeran) 6 mg/m2 PO once per day on days 1 to 42
- Rituximab (Rituxan) 375 mg/m2 IV once per day on days 1, 8, 15, 22
One course
Patients with stable disease or better proceeded to chlorambucil & rituximab consolidation.
References
- Zucca E, Conconi A, Laszlo D, López-Guillermo A, Bouabdallah R, Coiffier B, Sebban C, Jardin F, Vitolo U, Morschhauser F, Pileri SA, Copie-Bergman C, Campo E, Jack A, Floriani I, Johnson P, Martelli M, Cavalli F, Martinelli G, Thieblemont C. Addition of rituximab to chlorambucil produces superior event-free survival in the treatment of patients with extranodal marginal-zone B-cell lymphoma: 5-year analysis of the IELSG-19 randomized study. J Clin Oncol. 2013 Feb 10;31(5):565-72. Epub 2013 Jan 7. link to original article contains verified protocol PubMed
- Update: Zucca E, Conconi A, Martinelli G, Bouabdallah R, Tucci A, Vitolo U, Martelli M, Pettengell R, Salles G, Sebban C, Guillermo AL, Pinotti G, Devizzi L, Morschhauser F, Tilly H, Torri V, Hohaus S, Ferreri AJM, Zachée P, Bosly A, Haioun C, Stelitano C, Bellei M, Ponzoni M, Moreau A, Jack A, Campo E, Mazzucchelli L, Cavalli F, Johnson P, Thieblemont C. Final results of the IELSG-19 randomized trial of mucosa-associated lymphoid tissue lymphoma: improved event-free and progression-free survival with rituximab plus chlorambucil versus either chlorambucil or rituximab monotherapy. J Clin Oncol. 2017 Jun 10;35(17):1905-1912. Epub 2017 Mar 29. link to original articlePubMed
Fludarabine monotherapy
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Regimen
Study | Evidence | Comparator | Efficacy |
---|---|---|---|
Leblond et al. 2012 (WM1) | Phase III | Chlorambucil | Seems to have superior OS |
Chemotherapy
- Fludarabine (Fludara) 40 mg/m2 (30 mg/m2 per day if older than 75 years old) PO once per day on days 1 to 5
Supportive medications
- Recommended PCP prophylaxis with ONE of the following:
- Trimethoprim/Sulfamethoxazole (Bactrim SS) 1 tablet PO once per day
- Pentamidine (Nebupent) 300 mg inhaled once per month
- Herpes zoster prophylaxis with ONE of the following:
- Valacyclovir (Valtrex) 500 mg PO once per day
- Acyclovir (Zovirax) 200 to 400 mg PO BID
28-day cycle for up to 6 cycles
References
- Leblond V, Johnson S, Chevret S, Copplestone A, Rule S, Tournilhac O, Seymour JF, Patmore RD, Wright D, Morel P, Dilhuydy MS, Willoughby S, Dartigeas C, Malphettes M, Royer B, Ewings M, Pratt G, Lejeune J, Nguyen-Khac F, Choquet S, Owen RG. Results of a randomized trial of chlorambucil versus fludarabine for patients with untreated waldenstrom macroglobulinemia, marginal zone lymphoma, or lymphoplasmacytic lymphoma. J Clin Oncol. 2013 Jan 20;31(3):301-7. Epub 2012 Dec 10. link to original article contains verified protocol PubMed
R-CHOP
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R-CHOP: Rituximab, Cyclophosphamide, Hydroxydaunorubicin (Doxorubicin), Oncovin (Vincristine), Prednisone
Synonyms: R-CHOP-21, CHOP-R
Structured Concept: C9760 (NCI-T), C0393023 (NCI-MT/UMLS)
Example orders
Regimen
Study | Evidence | Comparator | Efficacy |
---|---|---|---|
Flinn et al. 2014 (BRIGHT) | Phase III, <20 in this arm | BR | Seems not superior |
R-CVP | Seems not superior |
Chemotherapy
- Rituximab (Rituxan) 375 mg/m2 IV once on day 1
- Cyclophosphamide (Cytoxan) 750 mg/m2 IV once on day 1
- Doxorubicin (Adriamycin) 50 mg/m2 IV once on day 1
- Vincristine (Oncovin) 1.4 mg/m2 (maximum dose of 2 mg per cycle) IV once on day 1
- Prednisone (Sterapred) 100 mg PO once per day on days 1 to 5
Supportive medications
- Antiemetics, antipyretics, and antibiotics per local standard of care
- G-CSF "according to the American Society of Clinical Oncology guidelines"
21-day cycle for up to 8 cycles
References
- Flinn IW, van der Jagt R, Kahl BS, Wood P, Hawkins TE, Macdonald D, Hertzberg M, Kwan YL, Simpson D, Craig M, Kolibaba K, Issa S, Clementi R, Hallman DM, Munteanu M, Chen L, Burke JM. Randomized trial of bendamustine-rituximab or R-CHOP/R-CVP in first-line treatment of indolent NHL or MCL: the BRIGHT study. Blood. 2014 May 8;123(19):2944-52. Epub 2014 Mar 3. link to original article contains verified protocol link to PMC article PubMed
- Update: Abstract: Ian Flinn, Richard van der Jagt, Julie E. Chang, Peter Wood, Tim E. Hawkins, David MacDonald, Judith Trotman, David Simpson, Kathryn S. Kolibaba, Samar Issa, Doreen M. Hallman, Ling Chen, and John M. Burke. First-line treatment of iNHL or MCL patients with BR or R-CHOP/R-CVP: Results of the BRIGHT 5-year follow-up study. Journal of Clinical Oncology 2017 35:15_suppl, 7500-7500 link to abstract
R-CVP
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R-CVP: Rituximab, Cyclophosphamide, Vincristine, Prednisone
Regimen
Study | Evidence | Comparator | Efficacy |
---|---|---|---|
Flinn et al. 2014 (BRIGHT) | Phase III, <20 in this arm | BR | Seems not superior |
R-CHOP | Seems not superior |
Chemotherapy
- Rituximab (Rituxan) 375 mg/m2 IV once on day 1
- Cyclophosphamide (Cytoxan) 750 mg/m2 or 1000 mg/m2 IV once on day 1
- Vincristine (Oncovin) 1.4 mg/m2 (maximum dose of 2 mg per cycle) IV once on day 1
- Prednisone (Sterapred) 100 mg PO once per day on days 1 to 5
Supportive medications
- Antiemetics, antipyretics, and antibiotics per local standard of care
- G-CSF "according to the American Society of Clinical Oncology guidelines"
21-day cycle for up to 8 cycles
References
- Flinn IW, van der Jagt R, Kahl BS, Wood P, Hawkins TE, Macdonald D, Hertzberg M, Kwan YL, Simpson D, Craig M, Kolibaba K, Issa S, Clementi R, Hallman DM, Munteanu M, Chen L, Burke JM. Randomized trial of bendamustine-rituximab or R-CHOP/R-CVP in first-line treatment of indolent NHL or MCL: the BRIGHT study. Blood. 2014 May 8;123(19):2944-52. Epub 2014 Mar 3. link to original article contains verified protocol link to PMC article PubMed
Rituximab monotherapy
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Regimen
Study | Evidence | Comparator | Efficacy |
---|---|---|---|
Conconi et al. 2003 (IELSG 6) | Phase II | ||
Martinelli et al. 2005 | Phase II | ||
Williams et al. 2016 (RESORT) | Non-randomized | ||
Zucca et al. 2017 (IELSG-19) | Phase III | Chlorambucil | Seems not superior |
Chlorambucil & Rituximab | Seems to have inferior PFS |
Chemotherapy
- Rituximab (Rituxan) 375 mg/m2 IV once per week; initial infusion rate of 50 mg/H, then increased as tolerated by 50 mg/H every 30 minutes, to a maximum rate of 300 mg/H
Supportive medications
- Acetaminophen (Tylenol) 650 mg PO 30 minutes prior to each dose
- Diphenhydramine (Benadryl) 50 mg PO 30 minutes prior to each dose
4-week course
Patients with PR/CR in RESORT were randomized to indefinite rituximab versus salvage rituximab at time of progression.
References
- Conconi A, Martinelli G, Thiéblemont C, Ferreri AJ, Devizzi L, Peccatori F, Ponzoni M, Pedrinis E, Dell'Oro S, Pruneri G, Filipazzi V, Dietrich PY, Gianni AM, Coiffier B, Cavalli F, Zucca E. Clinical activity of rituximab in extranodal marginal zone B-cell lymphoma of MALT type. Blood. 2003 Oct 15;102(8):2741-5. link to orginal article contains verified protocol PubMed content property of HemOnc.org
- Martinelli G, Laszlo D, Ferreri AJ, Pruneri G, Ponzoni M, Conconi A, Crosta C, Pedrinis E, Bertoni F, Calabrese L, Zucca E. Clinical activity of rituximab in gastric marginal zone non-Hodgkin's lymphoma resistant to or not eligible for anti-Helicobacter pylori therapy. J Clin Oncol. 2005 Mar 20;23(9):1979-83. link to original article contains verified protocol PubMed
- Williams ME, Hong F, Gascoyne RD, Wagner LI, Krauss JC, Habermann TM, Swinnen LJ, Schuster SJ, Peterson CG, Sborov MD, Martin SE, Weiss M, Ehmann WC, Horning SJ, Kahl BS. Rituximab extended schedule or retreatment trial for low tumour burden non-follicular indolent B-cell non-Hodgkin lymphomas: Eastern Cooperative Oncology Group Protocol E4402. Br J Haematol. 2016 Jun;173(6):867-75. Epub 2016 Mar 11. link to original article contains protocol link to PMC article PubMed
- Zucca E, Conconi A, Martinelli G, Bouabdallah R, Tucci A, Vitolo U, Martelli M, Pettengell R, Salles G, Sebban C, Guillermo AL, Pinotti G, Devizzi L, Morschhauser F, Tilly H, Torri V, Hohaus S, Ferreri AJM, Zachée P, Bosly A, Haioun C, Stelitano C, Bellei M, Ponzoni M, Moreau A, Jack A, Campo E, Mazzucchelli L, Cavalli F, Johnson P, Thieblemont C. Final results of the IELSG-19 randomized trial of mucosa-associated lymphoid tissue lymphoma: improved event-free and progression-free survival with rituximab plus chlorambucil versus either chlorambucil or rituximab monotherapy. J Clin Oncol. 2017 Jun 10;35(17):1905-1912. Epub 2017 Mar 29. link to original article PubMed
First-line therapy, non-randomized or retrospective data
Note: This implies chemotherapy-naive. Some patients in the following studies, especially those with gastric MALT, received H. pylori eradication therapy or radiation prior to chemotherapy.
Bortezomib monotherapy
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Regimen
Study | Evidence |
---|---|
Troch et al. 2009 | Phase II |
Chemotherapy
- Bortezomib (Velcade) 1.5 mg/m2 IV bolus once per day on days 1, 4, 8, 11
Supportive medications
- 5-HT3 antagonist IV immediately before Bortezomib (Velcade)
- 500 mL NS after Bortezomib (Velcade)
21-day cycle for up to 8 cycles
References
- Troch M, Jonak C, Müllauer L, Püspök A, Formanek M, Hauff W, Zielinski CC, Chott A, Raderer M. A phase II study of bortezomib in patients with MALT lymphoma. Haematologica. 2009 May;94(5):738-42. Epub 2009 Mar 31. link to original article contains verified protocol link to PMC article PubMed
Cladribine monotherapy
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Regimen
Study | Evidence |
---|---|
Jäger et al. 2002 | Phase II |
Chemotherapy
- Cladribine (Leustatin) 0.12 mg/kg IV over 2 hours once on days 1 to 5
28-day cycle for 4 to 6 cycles
Dose reductions
- "In case of a persisting nadir of the WBC count less than or equal to 4.0 × 109/L (or ANC less than or equal to 1500/uL) and/or the platelets less than or equal to 100 × 109/L, the next treatment cycle was delayed by 1 week until achieving normal values and then treatment was administered at a reduced dose of 0.1 mg/kg body weight."
References
- Jäger G, Neumeister P, Brezinschek R, Hinterleitner T, Fiebiger W, Penz M, Neumann HJ, Mlineritsch B, DeSantis M, Quehenberger F, Chott A, Beham-Schmid C, Höfler G, Linkesch W, Raderer M. Treatment of extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue type with cladribine: a phase II study. J Clin Oncol. 2002 Sep 15;20(18):3872-7. link to original article contains verified protocol PubMed
Cladribine & Rituximab
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Regimen
Study | Evidence |
---|---|
Troch et al. 2012 | Phase II |
Chemotherapy
- Cladribine (Leustatin) 0.1 mg/kg SC once per day on days 1 to 4
- Rituximab (Rituxan) 375 mg/m2 IV once on day 1
Supportive medications
- Acetaminophen (Tylenol) 1000 mg PO prior to Rituximab (Rituxan)
- Antihistamine IV prior to Rituximab (Rituxan)
- Either Ondansetron (Zofran) or Tropisetron (Navoban) IV immediately before Cladribine (Leustatin)
21-day cycle for up to 6 cycles
References
- Troch M, Kiesewetter B, Willenbacher W, Willenbacher E, Zebisch A, Linkesch W, Fridrik M, Müllauer L, Greil R, Raderer M. Rituximab plus subcutaneous cladribine in patients with extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue: a phase II study by the Arbeitsgemeinschaft Medikamentose Tumortherapie. Haematologica. 2013 Feb;98(2):264-8. Epub 2012 Sep 14. link to original article contains verified protocol link to PMC article PubMed
Doxycycline
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Regimen
Study | Evidence |
---|---|
Ferreri et al. 2006 | Phase II, <20 patients in this subgroup |
Ferreri et al. 2012 | Phase II |
This treatment was intended for patients with ocular adnexal marginal zone lymphoma (OAMZL), given the association with Chlamydia psittaci.
Antibiotic therapy
- Doxycycline 100 mg PO BID
3-week course
References
- Ferreri AJ, Ponzoni M, Guidoboni M, Resti AG, Politi LS, Cortelazzo S, Demeter J, Zallio F, Palmas A, Muti G, Dognini GP, Pasini E, Lettini AA, Sacchetti F, De Conciliis C, Doglioni C, Dolcetti R. Bacteria-eradicating therapy with doxycycline in ocular adnexal MALT lymphoma: a multicenter prospective trial. J Natl Cancer Inst. 2006 Oct 4;98(19):1375-82. link to original article contains verified protocol PubMed
- Ferreri AJ, Govi S, Pasini E, Mappa S, Bertoni F, Zaja F, Montalbán C, Stelitano C, Cabrera ME, Giordano Resti A, Politi LS, Doglioni C, Cavalli F, Zucca E, Ponzoni M, Dolcetti R. Chlamydophila psittaci eradication with doxycycline as first-line targeted therapy for ocular adnexae lymphoma: final results of an international phase II trial. J Clin Oncol. 2012 Aug 20;30(24):2988-94. Epub 2012 Jul 16. Erratum in: J Clin Oncol. 2012 Nov 1;30(31):3903. link to original article contains verified protocol PubMed
Fludarabine & Rituximab
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Regimen
Study | Evidence |
---|---|
Salar et al. 2009 | Phase II |
Chemotherapy
- Fludarabine (Fludara) 25 mg/m2 IV (or 40 mg/m2 PO) once per day on days 1 to 5
- Patients with gastric lymphoma received the cycle 1 dose intravenously to guarantee drug absorption
- Rituximab (Rituxan) 375 mg/m2 IV once on day 1
Dose reductions:
- Patients greater than 70 years old could receive Fludarabine (Fludara) at the above dose, but only once per day on days 1 to 3
Supportive medications
- Trimethoprim/Sulfamethoxazole prophylaxis (dose/schedule not listed) per physician preference
- No routine antiviral prophylaxis or G-CSF use
28-day cycles for 4-6 cycles
References
- Salar A, Domingo-Domenech E, Estany C, Canales MA, Gallardo F, Servitje O, Fraile G, Montalbán C. Combination therapy with rituximab and intravenous or oral fludarabine in the first-line, systemic treatment of patients with extranodal marginal zone B-cell lymphoma of the mucosa-associated lymphoid tissue type. Cancer. 2009 Nov 15;115(22):5210-7. link to orginal article contains verified protocol PubMed
Ibritumomab tiuxetan monotherapy
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Regimen
Study | Evidence |
---|---|
Samaniego et al. 2014 | Phase II, <20 patients reported |
Lossos et al. 2014 | Phase II, <20 patients reported |
Chemotherapy
- Rituximab (Rituxan) 250 mg/m2 IV once on day 1, then another single dose on day 8
- Ibritumomab tiuxetan & Yttrium-90 (Zevalin) 14.8 MBq/kg (maximum dose of 1184 MBq) IV once on day 8, given after Rituximab (Rituxan)
Dose reductions:
- Ibritumomab tiuxetan & Yttrium-90 (Zevalin) 11.1 MBq/kg (maximum dose of 1184 MBq) for platelet count between 100 and 149 × 109/L.
One course of therapy
References
- Samaniego F, Berkova Z, Romaguera JE, Fowler N, Fanale MA, Pro B, Shah JJ, McLaughlin P, Sehgal L, Selvaraj V, Braun FK, Mathur R, Feng L, Neelapu SS, Kwak LW. 90Y-ibritumomab tiuxetan radiotherapy as first-line therapy for early stage low-grade B-cell lymphomas, including bulky disease. Br J Haematol. 2014 Oct;167(2):207-13. Epub 2014 Jul 8. link to original article contains verified protocol PubMed
- Lossos IS, Fabregas JC, Koru-Sengul T, Miao F, Goodman D, Serafini AN, Hosein PJ, Stefanovic A, Rosenblatt JD, Hoffman JE. Phase II study of (90)Y Ibritumomab tiuxetan (Zevalin) in patients with previously untreated marginal zone lymphoma. Leuk Lymphoma. 2015 Jun;56(6):1750-5. Epub 2014 Nov 20. link to original article PubMed
Lenalidomide monotherapy
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Regimen
Study | Evidence |
---|---|
Kiesewetter et al. 2012 | Phase II, <20 patients reported |
Chemotherapy
- Lenalidomide (Revlimid) 25 mg PO once per day on days 1 to 21
Supportive medications
- Aspirin 100 mg PO once per day
28-day cycle for up to 6 cycles
References
- Kiesewetter B, Troch M, Dolak W, Müllauer L, Lukas J, Zielinski CC, Raderer M. A phase II study of lenalidomide in patients with extranodal marginal zone B-cell lymphoma of the mucosa associated lymphoid tissue (MALT lymphoma). Haematologica. 2013 Mar;98(3):353-6. Epub 2012 Aug 16. link to orginal article contains verified protocol link to PMC article PubMed
Lenalidomide & Rituximab
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Regimen
Study | Evidence |
---|---|
Fowler et al. 2014 | Phase II |
Kiesewetter et al. 2016 (AGMT MALT-2) | Phase II |
Chemotherapy
- Lenalidomide (Revlimid) 20 mg PO once per day on days 1 to 21
- Rituximab (Rituxan) 375 mg/m2 IV once on day 1
28-day cycle for up to 8 to 12 cycles
References
- Fowler NH, Davis RE, Rawal S, Nastoupil L, Hagemeister FB, McLaughlin P, Kwak LW, Romaguera JE, Fanale MA, Fayad LE, Westin JR, Shah J, Orlowski RZ, Wang M, Turturro F, Oki Y, Claret LC, Feng L, Baladandayuthapani V, Muzzafar T, Tsai KY, Samaniego F, Neelapu SS. Safety and activity of lenalidomide and rituximab in untreated indolent lymphoma: an open-label, phase 2 trial. Lancet Oncol. 2014 Nov;15(12):1311-8. Epub 2014 Oct 15. link to original article contains protocol link to PMC article PubMed
- Kiesewetter B, Willenbacher E, Willenbacher W, Egle A, Neumeister P, Voskova D, Mayerhoefer ME, Simonitsch-Klupp I, Melchardt T, Greil R, Raderer M; AGMT Investigators. A phase 2 study of rituximab plus lenalidomide for mucosa-associated lymphoid tissue lymphoma. Blood. 2017 Jan 19;129(3):383-385. Epub 2016 Nov 22. link to original article contains verified protocol PubMed
MCP
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MCP: Mitoxantrone, Chlorambucil, Prednisolone
Regimen
Study | Evidence |
---|---|
Wöhrer et al. 2003 | Retrospective |
Chemotherapy
- Mitoxantrone (Novantrone) 8 mg/m2 IV once per day on days 1 & 2
- Chlorambucil (Leukeran) 3 mg/m2 PO TID (written in the reference as "3 x 3 mg/m2"; total dose per day is 9 mg/m2) on days 1 to 5
- Prednisolone (Millipred) 25 mg/m2 PO/IV once per day on days 1 to 5
28-day cycle for up to 8 cycles
References
- Retrospective: Wöhrer S, Drach J, Hejna M, Scheithauer W, Dirisamer A, Püspök A, Chott A, Raderer M. Treatment of extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) with mitoxantrone, chlorambucil and prednisone (MCP). Ann Oncol. 2003 Dec;14(12):1758-61. link to orginal article contains verified protocol PubMed
PCR
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PCR: Pentostatin, Cyclophosphamide, Rituximab
Regimen
Study | Evidence |
---|---|
Samaniego et al. 2015 | Phase II, <20 patients in this subgroup |
Chemotherapy
- Pentostatin (Nipent) 4 mg/m2 IV once on day 1
- Cyclophosphamide (Cytoxan) 600 mg/m2 IV once on day 1
- Rituximab (Rituxan) 375 mg/m2 IV once on day 1
Supportive medications
- Ondansetron (Zofran) 8 mg (route not specified) prior to chemo
- Diphenhydramine (Benadryl) 25 mg (route not specified) prior to chemo
- 500 ml of 5% dextrose/one-half normal saline before and after each pentostatin dose
- Filgrastim (Neupogen) at the discretion of the treating physician
- Allopurinol (Zyloprim) 300 mg PO once per day on days 1 to 15 of cycle 1
- Trimethoprim/Sulfamethoxazole (Bactrim DS) once per day three days per week during and for 1 month following therapy
- Acyclovir (Zovirax) 400 mg PO BID during and for 1 month following therapy
21-day cycle for 6 cycles
References
- Samaniego F, Hagemeister F, Romaguera JE, Fanale MA, Pro B, McLaughlin P, Rodriguez MA, Neelapu SS, Fayad L, Younes A, Feng L, Berkova Z, Khashab T, Sehgal L, Vega-Vasquez F, Kwak LW. Pentostatin, cyclophosphamide and rituximab for previously untreated advanced stage, low-grade B-cell lymphomas. Br J Haematol. 2015 Jun;169(6):814-23. Epub 2015 Mar 31. link to original article contains verified protocol link to PMC article PubMed
Consolidation after first-line therapy
Chlorambucil monotherapy
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Regimen
Study | Evidence |
---|---|
Zucca et al. 2013 (IELSG-19) | Non-randomized portion of RCT |
Preceding treatment
Chemotherapy
- Chlorambucil (Leukeran) 6 mg/m2 PO once per day on days 1 to 14
28-day cycle for up to 4 cycles
References
- Zucca E, Conconi A, Laszlo D, López-Guillermo A, Bouabdallah R, Coiffier B, Sebban C, Jardin F, Vitolo U, Morschhauser F, Pileri SA, Copie-Bergman C, Campo E, Jack A, Floriani I, Johnson P, Martelli M, Cavalli F, Martinelli G, Thieblemont C. Addition of Rituximab to Chlorambucil Produces Superior Event-Free Survival in the Treatment of Patients With Extranodal Marginal-Zone B-Cell Lymphoma: 5-Year Analysis of the IELSG-19 Randomized Study. J Clin Oncol. 2013 Feb 10;31(5):565-72. Epub 2013 Jan 7. link to original article contains verified protocol PubMed
- Update: Zucca E, Conconi A, Martinelli G, Bouabdallah R, Tucci A, Vitolo U, Martelli M, Pettengell R, Salles G, Sebban C, Guillermo AL, Pinotti G, Devizzi L, Morschhauser F, Tilly H, Torri V, Hohaus S, Ferreri AJM, Zachée P, Bosly A, Haioun C, Stelitano C, Bellei M, Ponzoni M, Moreau A, Jack A, Campo E, Mazzucchelli L, Cavalli F, Johnson P, Thieblemont C. Final results of the IELSG-19 randomized trial of mucosa-associated lymphoid tissue lymphoma: improved event-free and progression-free survival with rituximab plus chlorambucil versus either chlorambucil or rituximab monotherapy. J Clin Oncol. 2017 Jun 10;35(17):1905-1912. Epub 2017 Mar 29. link to original articlePubMed
Chlorambucil & Rituximab
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Regimen
Study | Evidence |
---|---|
Zucca et al. 2013 (IELSG-19) | Non-randomized portion of RCT |
Preceding treatment
Chemotherapy
- Chlorambucil (Leukeran) 6 mg/m2 PO once per day on days 1 to 14
- Rituximab (Rituxan) 375 mg/m2 IV once on day 1
28-day cycle for up to 4 cycles
References
- Zucca E, Conconi A, Laszlo D, López-Guillermo A, Bouabdallah R, Coiffier B, Sebban C, Jardin F, Vitolo U, Morschhauser F, Pileri SA, Copie-Bergman C, Campo E, Jack A, Floriani I, Johnson P, Martelli M, Cavalli F, Martinelli G, Thieblemont C. Addition of Rituximab to Chlorambucil Produces Superior Event-Free Survival in the Treatment of Patients With Extranodal Marginal-Zone B-Cell Lymphoma: 5-Year Analysis of the IELSG-19 Randomized Study. J Clin Oncol. 2013 Feb 10;31(5):565-72. Epub 2013 Jan 7. link to original article contains verified protocol PubMed
- Update: Zucca E, Conconi A, Martinelli G, Bouabdallah R, Tucci A, Vitolo U, Martelli M, Pettengell R, Salles G, Sebban C, Guillermo AL, Pinotti G, Devizzi L, Morschhauser F, Tilly H, Torri V, Hohaus S, Ferreri AJM, Zachée P, Bosly A, Haioun C, Stelitano C, Bellei M, Ponzoni M, Moreau A, Jack A, Campo E, Mazzucchelli L, Cavalli F, Johnson P, Thieblemont C. Final results of the IELSG-19 randomized trial of mucosa-associated lymphoid tissue lymphoma: improved event-free and progression-free survival with rituximab plus chlorambucil versus either chlorambucil or rituximab monotherapy. J Clin Oncol. 2017 Jun 10;35(17):1905-1912. Epub 2017 Mar 29. link to original articlePubMed
Rituximab monotherapy
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Regimen
Study | Evidence | Comparator | Efficacy |
---|---|---|---|
Williams et al. 2016 (RESORT) | Phase III | Salvage rituximab | Seems to have superior TTTF |
Preceding treatment
Chemotherapy
- Rituximab (Rituxan) 375 mg/m2 IV once every 13 weeks
Continued until treatment failure
References
- Williams ME, Hong F, Gascoyne RD, Wagner LI, Krauss JC, Habermann TM, Swinnen LJ, Schuster SJ, Peterson CG, Sborov MD, Martin SE, Weiss M, Ehmann WC, Horning SJ, Kahl BS. Rituximab extended schedule or retreatment trial for low tumour burden non-follicular indolent B-cell non-Hodgkin lymphomas: Eastern Cooperative Oncology Group Protocol E4402. Br J Haematol. 2016 Jun;173(6):867-75. Epub 2016 Mar 11. link to original article contains protocol link to PMC article PubMed
Relapsed or refractory, non-randomized or retrospective data
Bendamustine monotherapy
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Regimen
Study | Evidence |
---|---|
Kahl et al. 2010 | Phase II, <20 patients reported |
Chemotherapy
Note: these infusion instructions are for the Treanda formulation, which was discontinued on 3/31/2016.
- Bendamustine 120 mg/m2 IV over 60 to 120 minutes once on days 1 & 2
21-day cycle for 6 to 8 cycles
References
- Kahl BS, Bartlett NL, Leonard JP, Chen L, Ganjoo K, Williams ME, Czuczman MS, Robinson KS, Joyce R, van der Jagt RH, Cheson BD. Bendamustine is effective therapy in patients with rituximab-refractory, indolent B-cell non-Hodgkin lymphoma: results from a Multicenter Study. Cancer. 2010 Jan 1;116(1):106-14. link to original article contains verified protocol link to PMC article PubMed
Bortezomib monotherapy
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Regimen #1
Study | Evidence |
---|---|
Conconi et al. 2011 | Phase II |
Chemotherapy
- Bortezomib (Velcade) 1.3 mg/m2 IV once per day on days 1, 4, 8, 11
Supportive medications
- No routine growth factors, antibiotic, or antiviral prophylaxis was given
21-day cycle for up to 6 cycles
Regimen #2
Study | Evidence |
---|---|
Troch et al. 2009 | Phase II |
- Bortezomib (Velcade) 1.5 mg/m2 IV bolus once per day on days 1, 4, 8, 11
Supportive medications
- 5-HT3 antagonist IV immediately before Bortezomib (Velcade)
- 500 mL NS after Bortezomib (Velcade)
21-day cycle for up to 8 cycles
References
- Troch M, Jonak C, Müllauer L, Püspök A, Formanek M, Hauff W, Zielinski CC, Chott A, Raderer M. A phase II study of bortezomib in patients with MALT lymphoma. Haematologica. 2009 May;94(5):738-42. Epub 2009 Mar 31. link to original article contains verified protocol link to PMC article PubMed
- Conconi A, Martinelli G, Lopez-Guillermo A, Zinzani PL, Ferreri AJ, Rigacci L, Devizzi L, Vitolo U, Luminari S, Cavalli F, Zucca E; International Extranodal Lymphoma Study Group (IELSG). Clinical activity of bortezomib in relapsed/refractory MALT lymphomas: results of a phase II study of the International Extranodal Lymphoma Study Group (IELSG). Ann Oncol. 2011 Mar;22(3):689-95. link to original article contains verified protocol PubMed
BR
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BR: Bendamustine, Rituximab
Regimen
Study | Evidence |
---|---|
Rummel et al. 2005 | Phase II, <20 patients in this subgroup |
Chemotherapy
Note: the bendamustine infusion instructions are for the Treanda formulation, which was discontinued on 3/31/2016.
- Rituximab (Rituxan) as follows:
- One week prior to start of cycle 1: 375 mg/m2 IV once
- Cycles 1 to 4: 375 mg/m2 IV once on day 1
- 4 weeks after cycle 4: 375 mg/m2 IV once
- Bendamustine 90 mg/m2 IV over 30 minutes once per day on days 2 & 3
28-day cycle for 4 cycles
References
- Rummel MJ, Al-Batran SE, Kim SZ, Welslau M, Hecker R, Kofahl-Krause D, Josten KM, Dürk H, Rost A, Neise M, von Grünhagen U, Chow KU, Hansmann ML, Hoelzer D, Mitrou PS. Bendamustine plus rituximab is effective and has a favorable toxicity profile in the treatment of mantle cell and low-grade non-Hodgkin's lymphoma. J Clin Oncol. 2005 May 20;23(15):3383-9. link to original article contains verified protocol PubMed
Cladribine & Rituximab
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Regimen
Study | Evidence |
---|---|
Troch et al. 2012 | Phase II, <20 patients reported |
Chemotherapy
- Cladribine (Leustatin) 0.1 mg/kg SC once per day on days 1 to 4
- Rituximab (Rituxan) 375 mg/m2 IV once on day 1
Supportive medications
- Acetaminophen (Tylenol) 1000 mg PO prior to Rituximab (Rituxan)
- Antihistamine IV prior to Rituximab (Rituxan)
- Either Ondansetron (Zofran) or Tropisetron (Navoban) IV immediately before Cladribine (Leustatin)
21-day cycle for up to 6 cycles
References
- Troch M, Kiesewetter B, Willenbacher W, Willenbacher E, Zebisch A, Linkesch W, Fridrik M, Müllauer L, Greil R, Raderer M. Rituximab plus subcutaneous cladribine in patients with extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue: a phase II study by the Arbeitsgemeinschaft Medikamentose Tumortherapie. Haematologica. 2013 Feb;98(2):264-8. Epub 2012 Sep 14. link to original article contains verified protocol link to PMC article PubMed
Clarithromycin monotherapy
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Regimen
Study | Evidence |
---|---|
Ferreri et al. 2015 (HD-K) | Phase II |
Antibiotic therapy
- Clarithromycin (Biaxin) 2 g PO once per day on days 1 to 14
21-day cycle for 4 cycles
References
- Ferreri AJ, Sassone M, Kiesewetter B, Govi S, Scarfò L, Donadoni G, Raderer M. High-dose clarithromycin is an active monotherapy for patients with relapsed/refractory extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT): the HD-K phase II trial. Ann Oncol. 2015 Aug;26(8):1760-5. Epub 2015 May 1. link to original article contains verified protocol PubMed
Doxycycline
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Regimen
Study | Evidence |
---|---|
Ferreri et al. 2006 | Phase II, <20 patients in this subgroup |
This treatment was intended for patients with ocular adnexal marginal zone lymphoma (OAMZL), given the association with Chlamydia psittaci.
Antibiotic therapy
- Doxycycline 100 mg PO BID
3-week course
References
- Ferreri AJ, Ponzoni M, Guidoboni M, Resti AG, Politi LS, Cortelazzo S, Demeter J, Zallio F, Palmas A, Muti G, Dognini GP, Pasini E, Lettini AA, Sacchetti F, De Conciliis C, Doglioni C, Dolcetti R. Bacteria-eradicating therapy with doxycycline in ocular adnexal MALT lymphoma: a multicenter prospective trial. J Natl Cancer Inst. 2006 Oct 4;98(19):1375-82. link to original article contains verified protocol PubMed
Idelalisib monotherapy
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On 3/21/2016 Gilead announced that they were stopping seven clinical trials of idelalisib in patients with CLL, SLL, and iNHL due to excess deaths and increased rates of SAEs. A REMS program has also been announced.
Regimen,
Study | Evidence |
---|---|
Gopal et al. 2014 (DELTA) | Phase II, <20 patients in this subgroup |
Chemotherapy
- Idelalisib (Zydelig) 150 mg PO BID
Continued until progression, death, or unacceptable toxicity
References
- Gopal AK, Kahl BS, de Vos S, Wagner-Johnston ND, Schuster SJ, Jurczak WJ, Flinn IW, Flowers CR, Martin P, Viardot A, Blum KA, Goy AH, Davies AJ, Zinzani PL, Dreyling M, Johnson D, Miller LL, Holes L, Li D, Dansey RD, Godfrey WR, Salles GA. PI3Kd Inhibition by Idelalisib in Patients with Relapsed Indolent Lymphoma. N Engl J Med. 2014 Jan 22. link to original article contains verified protocol link to PMC article PubMed
- Update: Abstract: Ajay K. Gopal, MD, Brad S. Kahl, MD, Sven de Vos, MD, PhD, Nina D. Wagner-Johnston, MD, Stephen J. Schuster, MD, Wojciech Jurczak, MD, PhD, Ian W. Flinn, MD, PhD, Christopher R. Flowers, MD, Peter Martin, MD, Andreas Viardot, MD, Kristie A. Blum, MD, Andre Goy, MD, Andrew Davies, BM PhD, Pier Luigi Zinzani, MD, Martin H. Dreyling, MD, PhD, Leanne M. Holes, Bess Sorensen, PhD, Wayne R. Godfrey, MD and Gilles Andre Salles, MD, PhD. Mature Follow up from a Phase 2 Study of PI3K-Delta Inhibitor Idelalisib in Patients with Double (Rituximab and Alkylating agent)-Refractory Indolent B-Cell Non-Hodgkin Lymphoma (iNHL). ASH Annual Meeting 2014, Abstract 1708 link to abstract
Ibrutinib monotherapy
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Regimen
Study | Evidence |
---|---|
Noy et al. 2016 (PCYC-1121-CA) | Phase II |
Chemotherapy
- Ibrutinib (Imbruvica) 560 mg PO once per day
Given until progression of disease or unacceptable toxicity
References
- Abstract: Ariela Noy, MD, PhD, Sven de Vos, MD, PhD, Catherine Thieblemont, MD, PhD, Peter Martin, MD, Christopher Flowers, MD, MS, Franck Morschhauser, MD, PhD, Graham P. Collins, MD, PhD, Shuo Ma, Morton Coleman, MD, Shachar Peles, MD, Stephen Smith, MD, Alina Smith, Brian Munneke, PhD, Isaiah Dimery, MD, Darrin Beaupre, MD, PhD and Robert W Chen, MD. Single-Agent Ibrutinib Demonstrates Efficacy and Safety in Patients with Relapsed/Refractory Marginal Zone Lymphoma: A Multicenter, Open-Label, Phase 2 Study. ASH 2016 Annual Meeting Abstract 1213. link to abstract ClinicalTrials.gov info
Lenalidomide monotherapy
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Regimen
Study | Evidence |
---|---|
Kiesewetter et al. 2012 | Phase II, <20 patients reported |
Chemotherapy
- Lenalidomide (Revlimid) 25 mg PO once per day on days 1 to 21
Supportive medications
- Aspirin 100 mg PO once per day
28-day cycle for up to 6 cycles
References
- Kiesewetter B, Troch M, Dolak W, Müllauer L, Lukas J, Zielinski CC, Raderer M. A phase II study of lenalidomide in patients with extranodal marginal zone B-cell lymphoma of the mucosa associated lymphoid tissue (MALT lymphoma). Haematologica. 2013 Mar;98(3):353-6. Epub 2012 Aug 16. link to orginal article contains verified protocol link to PMC article PubMed
Ox-P
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Ox-P: Oxaliplatin & Prednisone
Regimen
Study | Evidence |
---|---|
Oh et al. 2016 (CISL) | Phase II |
Note: the treatment details state that prednisone was used, but later in the text prednisolone is mentioned. The authors have been contacted for clarification.
Chemotherapy
- Oxaliplatin (Eloxatin) 130 mg/m2 IV over 2 hours once on day 1
- Prednisone (Sterapred) 100 mg PO once per day on days 1 to 5 (see note)
21-day cycle for up to 6 cycles
References
- Oh SY, Kim WS, Kim JS, Chae YS, Lee GW, Eom HS, Ryoo HM, Lee S, Kim SJ, Yoon DH, Won JH, Hong J, Park J, Lee SM, Hong JY, Park E, Kim HJ, Yang DH, Kim HJ, Suh C. A phase II study of oxaliplatin and prednisone for patients with relapsed or refractory marginal zone lymphoma: Consortium for Improving Survival of Lymphoma trial. Leuk Lymphoma. 2016;57(6):1406-12. link to original article contains verified protocol PubMed
Rituximab monotherapy
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Regimen
Study | Evidence | Comparator | Efficacy |
---|---|---|---|
Conconi et al. 2003 | Phase II | ||
Martinelli et al. 2005 | Phase II | ||
Williams et al. 2016 (RESORT) | Phase III | Maintenance rituximab | Seems to have inferior TTTF |
In RESORT, treatment is given at time of progression.
Preceding treatment
- RESORT: Rituximab
Chemotherapy
- Rituximab (Rituxan) 375 mg/m2 IV once per day on days 1, 8, 15, 22
One course
References
- Conconi A, Martinelli G, Thiéblemont C, Ferreri AJ, Devizzi L, Peccatori F, Ponzoni M, Pedrinis E, Dell'Oro S, Pruneri G, Filipazzi V, Dietrich PY, Gianni AM, Coiffier B, Cavalli F, Zucca E. Clinical activity of rituximab in extranodal marginal zone B-cell lymphoma of MALT type. Blood. 2003 Oct 15;102(8):2741-5. link to orginal article contains protocol PubMed
- Martinelli G, Laszlo D, Ferreri AJ, Pruneri G, Ponzoni M, Conconi A, Crosta C, Pedrinis E, Bertoni F, Calabrese L, Zucca E. Clinical activity of rituximab in gastric marginal zone non-Hodgkin's lymphoma resistant to or not eligible for anti-Helicobacter pylori therapy. J Clin Oncol. 2005 Mar 20;23(9):1979-83. link to original article contains protocol PubMed
- Williams ME, Hong F, Gascoyne RD, Wagner LI, Krauss JC, Habermann TM, Swinnen LJ, Schuster SJ, Peterson CG, Sborov MD, Martin SE, Weiss M, Ehmann WC, Horning SJ, Kahl BS. Rituximab extended schedule or retreatment trial for low tumour burden non-follicular indolent B-cell non-Hodgkin lymphomas: Eastern Cooperative Oncology Group Protocol E4402. Br J Haematol. 2016 Jun;173(6):867-75. Epub 2016 Mar 11. link to original article contains protocol link to PMC article PubMed
Vorinostat monotherapy
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Regimen
Study | Evidence |
---|---|
Kirschbaum et al. 2011 | Phase II, <20 pts in subgroup |
Chemotherapy
- Vorinostat (Zolinza) 200 mg PO BID on days 1 to 14
21-day cycles until progression or unacceptable toxicity
References
- Kirschbaum M, Frankel P, Popplewell L, Zain J, Delioukina M, Pullarkat V, Matsuoka D, Pulone B, Rotter AJ, Espinoza-Delgado I, Nademanee A, Forman SJ, Gandara D, Newman E. Phase II study of vorinostat for treatment of relapsed or refractory indolent non-Hodgkin's lymphoma and mantle cell lymphoma. J Clin Oncol. 2011 Mar 20;29(9):1198-203. Epub 2011 Feb 7. link to original article contains verified protocol link to PMC article PubMed
Prognosis
MALT-IPI (2017)
Risk factors
- Stage III or IV
- Age older than 70 years
- LDH greater than the upper limit of normal
Calculation
- Low risk: zero risk factors present
- Intermediate risk: one risk factor present
- High risk: two or more risk factors present
References
- Thieblemont C, Cascione L, Conconi A, Kiesewetter B, Raderer M, Gaidano G, Martelli M, Laszlo D, Coiffier B, Lopez Guillermo A, Torri V, Cavalli F, Johnson PW, Zucca E. A MALT lymphoma prognostic index. Blood. 2017 Sep 21;130(12):1409-1417. Epub 2017 Jul 18. link to original article PubMed
Response criteria
NCI Sponsored International Working Group Criteria (1999)
- Cheson BD, Horning SJ, Coiffier B, Shipp MA, Fisher RI, Connors JM, Lister TA, Vose J, Grillo-López A, Hagenbeek A, Cabanillas F, Klippensten D, Hiddemann W, Castellino R, Harris NL, Armitage JO, Carter W, Hoppe R, Canellos GP. Report of an international workshop to standardize response criteria for non-Hodgkin's lymphomas. NCI Sponsored International Working Group. J Clin Oncol. 1999 Apr;17(4):1244. Review. Erratum in: J Clin Oncol 2000 Jun;18(11):2351. link to original article PubMed