Treatment for Ocular Adnexal Mucosa-Associated Lymphoid Tissue (OA-MALT) Lymphoma
Main Article Content
Abstract
Ocular adnexal mucosa-associated lymphoid tissue (OA-MALT) lymphoma is one of the B lymphoid malignancies that originates in the orbit and shows indolent progression with a predominantly localized stage. Radiotherapy appears to be recognized as the most common treatment for localized OA-MALT lymphoma. Surgical resection, eradication of Chlamydia psittaci (C. psittaci) based on the reports of the existence of C. psittaci DNA, and ‘watchful waiting’ are also selected in some cases. Systemic immunochemotherapies including anti-CD20 antibodies may be another option for advanced stages of OA-MALT lymphoma. However, due to the lower frequency of this disease and the difficulty of conducting large-scale clinical trials, no randomized, controlled trial evaluating these treatments has been reported. Therefore, the optimal treatment strategy for OA-MALT lymphoma has not been established. This review provides an update on treatments and discusses the appropriate treatment for OA-MALT lymphoma.
Keywords:
treatment, ocular adnexal mucosa-associated lymphoid tissue (OA-MALT) lymphoma, watchful waiting, Chlamydophilia psittaci (C. psittaci)
Article Details
How to Cite
TAKEUCHI, Kazuto; YAKUSHIJIN, Yoshihiro.
Treatment for Ocular Adnexal Mucosa-Associated Lymphoid Tissue (OA-MALT) Lymphoma.
Medical Research Archives, [S.l.], v. 9, n. 11, nov. 2021.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/2588>. Date accessed: 21 nov. 2024.
doi: https://doi.org/10.18103/mra.v9i11.2588.
Section
Review Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
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5. Thieblemont C. Clinical presentation and management of marginal zone lymphomas. Hematology Am Soc Hematol Educ Program. 2005: 307-313.
6. Zucca E, Conconi A, Pedrinis E, et al. Nongastric marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue. Blood. 2003; 101(7): 2489-2495.
7. Goda JS, Gospodarowicz M, Pintilie M, et al. Long-term outcome in localized extranodal mucosa-associated lymphoid tissue lymphomas treated with radiotherapy. Cancer. 2010; 116(16): 3815-3824.
8. Fung CY, Grossbard ML, Linggood RM, et al. Mucosa-associated lymphoid tissue lymphoma of the stomach: long term outcome after local treatment. Cancer. 1999; 85(1): 9-17.
9. Masuda Y, Takeuchi K, Kodama T, et al. Treatment-associated outcomes of patients with primary ocular adnexal MALT lymphoma after accurate diagnosis. Int J Clin Oncol. 2019; 24(12): 1620-1628.
10. Isobe K, Kagami Y, Higuchi K, et al. A multicenter phase Ⅱ study of local radiation therapy for stage IEA mucosa-associated lymphoid tissue lymphomas: a preliminary report from the Japan Radiation Oncology Group (JAROG). Int J Radiation Oncology Biol Physics. 2007; 69(4): 1181-1186.
11. Durkin SR, Roos D, Higgs B, et al. Ophthalmic and adnexal complications of radiotherapy. Acta Ophthalmol Scand. 2007; 85(3): 240-250.
12. Park HH, Lee SW, Sung SY, et al. Treatment outcome and risk analysis for cataract after radiotherapy of localized ocular adnexal mucosa-associated lymphoid tissue (MALT) lymphoma. Radiat Oncol J. 2017; 35(3): 249-256.
13. Bayraktar S, Bayraktar UD, Stefanovic A, et al. Primary ocular adnexal mucosa-associated lymphoid tissue lymphoma (MALT): single institution experience in a large cohort of patients. Br J Haematol. 2011; 152(1): 72-80.
14. Hashimoto N, Sasaki R, Kitaguchi M, et al. Long-term outcome and patients of failure in primary ocular adnexal mucosa-associated lymphoid tissue lymphoma treated with radiotherapy. Int J Radiat Oncol Biol Phys. 2012; 82(4): 1509-1514.
15. Ohga S, Nakamura K, Shioyama Y, et al. Treatment outcome of radiotherapy for localized primary ocular adnexal MALT lymphoma--prognostic effect of the AJCC Tumor-Node-Metastasis Clinical Staging System. Anticancer Res. 2015; 35(6): 3591-3597.
16. Lee MJ, Lee MY, Choe JY, et al. Ultra-low-dose radiation treatment for early-stage ocular adnexal MALT lymphoma. Eur J Ophthalmol. 2021 Jul 28. doi: 10.1177/11206721211035622. [Epub ahead of print]
17. Tanimoto K, Kaneko A, Suzuki S, et al. Long-term follow-up results of no initial therapy for ocular adnexal MALT lymphoma. Ann Oncol. 2006; 17(1): 135-140.
18. Tanimoto K, Kaneko A, Suzuki S, et al. Primary ocular adnexal MALT lymphoma: a long-term follow-up study of 114 patients. Jpn J Clin Oncol. 2007; 37(5): 337-344.
19. Matsuo T, Yoshino T. Long-term follow-up results of observation or radiation for conjunctival malignant lymphoma. Ophthalmology. 2004; 111(6): 1233-1237.
20. Savino G, Battendieri R, Ralia L, et al. Evaluation of intraorbital injection of ritsuximab for treatment of primary ocular adnexal lymphoma: a pilot study. Cancer Sci. 2012; 102(8): 1565-1567.
21. Song EK, Kim SY, Kim TM, et al. Efficacy of chemotherapy as a first-line treatment in ocular adnexal extranodal marginal zone B-cell lymphoma. Ann Oncol. 2008; 19(2): 242-246.
22. Kim SY, Yang SW, Lee WS, et al. Frontline treatment with chemoimmunotherapy for limited-stage ocular adnexal MALT lymphoma with adverse factors: a phase II study. Oncotarget. 2017; 8(40): 68583-68590.
23. Ben Simon GJ, Cheung N, McKelvie P, et al. Oral chlorambucil for extranodal, marginal zone, B-cell lymphoma of mucosa-associated lymphoid tissue of the orbit. Ophthalmology. 2006; 113(7): 1209-1213.
24. Rigacci L, Nassi L, Puccioni M, et al. Rituximab and chlorambucil as first-line treatment for low-grade ocular adnexal lymphomas. Ann Hematol. 2007; 86(8): 565-568.
25. Zinzani PL, Stefoni V, Musuraca G, et al. Fludarabine-containing chemotherapy as frontline treatment of nongastrointestinal mucosa-associated lymphoid tissue lymphoma. Cancer. 2004; 100(10): 2190-2194.
26. Jäger G, Neumeister P, Quehenberger F, et al. Prolonged clinical remission in patients with extranodal marginal zone B-cell lymphoma of the mucosa-associated lymphoid tissue type treated with cladribine: 6 year follow-up of a phase II trial. Ann Oncol. 2006; 17(11): 1722-1723.
27. Armitage JO, Tobinai K, Hoelzer D, et al. Treatment of indolent non-Hodgkin's lymphoma with cladribine as single-agent therapy and in combination with mitoxantrone. Int J Hematol. 2004; 79(4): 311-321.
28. Jäger G, Neumeister P, Brezinschek R, et al. Treatment of extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue type with cladribine: a phase II study. J Clin Oncol. 2002; 20(18): 3872-3877.
29. Zucca E, Conconi A, Laszlo D, et al. 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; 31(5): 565-572.
30. Lossos IS, Fabregas JC, Koru-Sengul T, et al. Phase II study of (90) Y ibritumomab tiuxetan (zevalin) in patients with previously untreated marginal zone lymphoma. Leuk Lymphoma. 2015; 56(6): 1750-1755.
31. Conconi A, Martinelli G, Lopez-Guillermo A, et al. 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; 22(3): 689-695.
32. Conconi A, Raderer M, Franceschetti S, et al. Clinical activity of everolimus in relapsed/refractory marginal zone B-cell lymphomas: results of a phase II study of the International Extranodal Lymphoma Study Group. Br J Haematol. 2014; 166(1): 69-76.
33. Kiesewetter B, Troch M, Dolak W, et al. 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; 98(3): 353-356.
34. Ferreri AJ, Guidoboni M, Ponzoni M, et al. Evidence for an association between Chlamydia psittaci and ocular adnexal lymphomas. J Natl Cancer Inst. 2004; 96(8): 586-594.
35. Ferreri AJ, Govi S, Pasini E, et al. 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; 30(24): 2988-2994.
36. Yakushijin Y, Kodama T, Takaoka I, et al. Absence of chlamydial infection in Japanese patients with ocular adnexal lymphoma of mucosa-associated lymphoid tissue. Int J Hematol. 2007; 85(3): 223-230.
37. Rosado MF, Byrne GE Jr, Ding F, et al. Ocular adnexal lymphoma: a clinicopathologic study of a large cohort of patients with no evidence for an association with Chlamydia psittaci. Blood. 2006; 107(2): 467-472.
38. Vargas RL, Fallone E, Felgar RE, et al. Is there an association between ocular adnexal lymphoma and infection with Chlamydia psittaci? The University of Rochester experience. Leuk Res. 2006; 30(5): 547-551.
39. Zhang GS, Winter JN, Variakojis D, et al. Lack of an association between Chlamydia psittaci and ocular adnexal lymphoma. Leuk Lymphoma. 2007; 48(3): 577-583.
40. Matthews JM, Moreno LI, Dennis J, et al. Ocular adnexal lymphoma: no evidence for bacterial DNA associated with lymphoma pathogenesis. Br J Haematol. 2008; 142(2): 246-249.
41. Mulder MM, Heddema ER, Pannekoek Y, et al. No evidence for an association of ocular adnexal lymphoma with Chlamydia psittaci in a cohort of patients from the Netherlands. Leuk Res. 2006; 30(10): 1305-1307.
42. DeCremoux P, Subtil A, Ferreri AJ, et al. Evidence for an association between Chlamydia psittaci and ocular adnexal lymphomas. J Natl Cancer Inst. 2006; 98(5): 365-366.
43. Ruiz A, Reischl U, Swerdlow SH, et al. Extranodal marginal zone B-cell lymphomas of the ocular adnexa: multiparameter analysis of 34 cases including interphase molecular cytogenetics and PCR for Chlamydia psittaci. Am J Surg Pathol. 2007; 31(5): 792-802.
44. Goebel N, Serr A, Mittelviefhaus H, et al. Chlamydia psittaci, Helicobacter pylori and ocular adnexal lymphoma-is there an association? The German experience. Leuk Res. 2007; 31(10): 1450-1452.
45. Daibata M, Nemoto Y, Togitani K, et al. Absence of Chlamydia psittaci in ocular adnexal lymphoma from Japanese patients. Br J Haematol. 2006; 132(5): 651-652.
46. Liu YC, Ohyashiki JH, Ito Y, et al. Chlamydia psittaci in ocular adnexal lymphoma: Japanese experience. Leuk Res. 2006; 30(12): 1587-1589.
2. Cousar JB, McGinn DL, Glick AD, et al. Report of an unusual lymphoma arising from parafollicular B-lymphocytes (PBLs) or so-called "monocytoid" lymphocytes. Am J Clin Pathol. 1987; 87(1): 121-128.
3. Wotherspoon AC, Ortiz-Hidalgo C, Falzon MR, et al. Helicobacter pylori-associated gastritis and primary B-cell gastric lymphoma. Lancet. 1991; 338(8776): 1175-1176.
4. National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology B-cell Lymphomas. Version 4.2021. Available from: https://www. https://www.nccn.org/professionals/physician_gls/pdf/b-cell.pdf. Accessed August 12, 2021.
5. Thieblemont C. Clinical presentation and management of marginal zone lymphomas. Hematology Am Soc Hematol Educ Program. 2005: 307-313.
6. Zucca E, Conconi A, Pedrinis E, et al. Nongastric marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue. Blood. 2003; 101(7): 2489-2495.
7. Goda JS, Gospodarowicz M, Pintilie M, et al. Long-term outcome in localized extranodal mucosa-associated lymphoid tissue lymphomas treated with radiotherapy. Cancer. 2010; 116(16): 3815-3824.
8. Fung CY, Grossbard ML, Linggood RM, et al. Mucosa-associated lymphoid tissue lymphoma of the stomach: long term outcome after local treatment. Cancer. 1999; 85(1): 9-17.
9. Masuda Y, Takeuchi K, Kodama T, et al. Treatment-associated outcomes of patients with primary ocular adnexal MALT lymphoma after accurate diagnosis. Int J Clin Oncol. 2019; 24(12): 1620-1628.
10. Isobe K, Kagami Y, Higuchi K, et al. A multicenter phase Ⅱ study of local radiation therapy for stage IEA mucosa-associated lymphoid tissue lymphomas: a preliminary report from the Japan Radiation Oncology Group (JAROG). Int J Radiation Oncology Biol Physics. 2007; 69(4): 1181-1186.
11. Durkin SR, Roos D, Higgs B, et al. Ophthalmic and adnexal complications of radiotherapy. Acta Ophthalmol Scand. 2007; 85(3): 240-250.
12. Park HH, Lee SW, Sung SY, et al. Treatment outcome and risk analysis for cataract after radiotherapy of localized ocular adnexal mucosa-associated lymphoid tissue (MALT) lymphoma. Radiat Oncol J. 2017; 35(3): 249-256.
13. Bayraktar S, Bayraktar UD, Stefanovic A, et al. Primary ocular adnexal mucosa-associated lymphoid tissue lymphoma (MALT): single institution experience in a large cohort of patients. Br J Haematol. 2011; 152(1): 72-80.
14. Hashimoto N, Sasaki R, Kitaguchi M, et al. Long-term outcome and patients of failure in primary ocular adnexal mucosa-associated lymphoid tissue lymphoma treated with radiotherapy. Int J Radiat Oncol Biol Phys. 2012; 82(4): 1509-1514.
15. Ohga S, Nakamura K, Shioyama Y, et al. Treatment outcome of radiotherapy for localized primary ocular adnexal MALT lymphoma--prognostic effect of the AJCC Tumor-Node-Metastasis Clinical Staging System. Anticancer Res. 2015; 35(6): 3591-3597.
16. Lee MJ, Lee MY, Choe JY, et al. Ultra-low-dose radiation treatment for early-stage ocular adnexal MALT lymphoma. Eur J Ophthalmol. 2021 Jul 28. doi: 10.1177/11206721211035622. [Epub ahead of print]
17. Tanimoto K, Kaneko A, Suzuki S, et al. Long-term follow-up results of no initial therapy for ocular adnexal MALT lymphoma. Ann Oncol. 2006; 17(1): 135-140.
18. Tanimoto K, Kaneko A, Suzuki S, et al. Primary ocular adnexal MALT lymphoma: a long-term follow-up study of 114 patients. Jpn J Clin Oncol. 2007; 37(5): 337-344.
19. Matsuo T, Yoshino T. Long-term follow-up results of observation or radiation for conjunctival malignant lymphoma. Ophthalmology. 2004; 111(6): 1233-1237.
20. Savino G, Battendieri R, Ralia L, et al. Evaluation of intraorbital injection of ritsuximab for treatment of primary ocular adnexal lymphoma: a pilot study. Cancer Sci. 2012; 102(8): 1565-1567.
21. Song EK, Kim SY, Kim TM, et al. Efficacy of chemotherapy as a first-line treatment in ocular adnexal extranodal marginal zone B-cell lymphoma. Ann Oncol. 2008; 19(2): 242-246.
22. Kim SY, Yang SW, Lee WS, et al. Frontline treatment with chemoimmunotherapy for limited-stage ocular adnexal MALT lymphoma with adverse factors: a phase II study. Oncotarget. 2017; 8(40): 68583-68590.
23. Ben Simon GJ, Cheung N, McKelvie P, et al. Oral chlorambucil for extranodal, marginal zone, B-cell lymphoma of mucosa-associated lymphoid tissue of the orbit. Ophthalmology. 2006; 113(7): 1209-1213.
24. Rigacci L, Nassi L, Puccioni M, et al. Rituximab and chlorambucil as first-line treatment for low-grade ocular adnexal lymphomas. Ann Hematol. 2007; 86(8): 565-568.
25. Zinzani PL, Stefoni V, Musuraca G, et al. Fludarabine-containing chemotherapy as frontline treatment of nongastrointestinal mucosa-associated lymphoid tissue lymphoma. Cancer. 2004; 100(10): 2190-2194.
26. Jäger G, Neumeister P, Quehenberger F, et al. Prolonged clinical remission in patients with extranodal marginal zone B-cell lymphoma of the mucosa-associated lymphoid tissue type treated with cladribine: 6 year follow-up of a phase II trial. Ann Oncol. 2006; 17(11): 1722-1723.
27. Armitage JO, Tobinai K, Hoelzer D, et al. Treatment of indolent non-Hodgkin's lymphoma with cladribine as single-agent therapy and in combination with mitoxantrone. Int J Hematol. 2004; 79(4): 311-321.
28. Jäger G, Neumeister P, Brezinschek R, et al. Treatment of extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue type with cladribine: a phase II study. J Clin Oncol. 2002; 20(18): 3872-3877.
29. Zucca E, Conconi A, Laszlo D, et al. 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; 31(5): 565-572.
30. Lossos IS, Fabregas JC, Koru-Sengul T, et al. Phase II study of (90) Y ibritumomab tiuxetan (zevalin) in patients with previously untreated marginal zone lymphoma. Leuk Lymphoma. 2015; 56(6): 1750-1755.
31. Conconi A, Martinelli G, Lopez-Guillermo A, et al. 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; 22(3): 689-695.
32. Conconi A, Raderer M, Franceschetti S, et al. Clinical activity of everolimus in relapsed/refractory marginal zone B-cell lymphomas: results of a phase II study of the International Extranodal Lymphoma Study Group. Br J Haematol. 2014; 166(1): 69-76.
33. Kiesewetter B, Troch M, Dolak W, et al. 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; 98(3): 353-356.
34. Ferreri AJ, Guidoboni M, Ponzoni M, et al. Evidence for an association between Chlamydia psittaci and ocular adnexal lymphomas. J Natl Cancer Inst. 2004; 96(8): 586-594.
35. Ferreri AJ, Govi S, Pasini E, et al. 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; 30(24): 2988-2994.
36. Yakushijin Y, Kodama T, Takaoka I, et al. Absence of chlamydial infection in Japanese patients with ocular adnexal lymphoma of mucosa-associated lymphoid tissue. Int J Hematol. 2007; 85(3): 223-230.
37. Rosado MF, Byrne GE Jr, Ding F, et al. Ocular adnexal lymphoma: a clinicopathologic study of a large cohort of patients with no evidence for an association with Chlamydia psittaci. Blood. 2006; 107(2): 467-472.
38. Vargas RL, Fallone E, Felgar RE, et al. Is there an association between ocular adnexal lymphoma and infection with Chlamydia psittaci? The University of Rochester experience. Leuk Res. 2006; 30(5): 547-551.
39. Zhang GS, Winter JN, Variakojis D, et al. Lack of an association between Chlamydia psittaci and ocular adnexal lymphoma. Leuk Lymphoma. 2007; 48(3): 577-583.
40. Matthews JM, Moreno LI, Dennis J, et al. Ocular adnexal lymphoma: no evidence for bacterial DNA associated with lymphoma pathogenesis. Br J Haematol. 2008; 142(2): 246-249.
41. Mulder MM, Heddema ER, Pannekoek Y, et al. No evidence for an association of ocular adnexal lymphoma with Chlamydia psittaci in a cohort of patients from the Netherlands. Leuk Res. 2006; 30(10): 1305-1307.
42. DeCremoux P, Subtil A, Ferreri AJ, et al. Evidence for an association between Chlamydia psittaci and ocular adnexal lymphomas. J Natl Cancer Inst. 2006; 98(5): 365-366.
43. Ruiz A, Reischl U, Swerdlow SH, et al. Extranodal marginal zone B-cell lymphomas of the ocular adnexa: multiparameter analysis of 34 cases including interphase molecular cytogenetics and PCR for Chlamydia psittaci. Am J Surg Pathol. 2007; 31(5): 792-802.
44. Goebel N, Serr A, Mittelviefhaus H, et al. Chlamydia psittaci, Helicobacter pylori and ocular adnexal lymphoma-is there an association? The German experience. Leuk Res. 2007; 31(10): 1450-1452.
45. Daibata M, Nemoto Y, Togitani K, et al. Absence of Chlamydia psittaci in ocular adnexal lymphoma from Japanese patients. Br J Haematol. 2006; 132(5): 651-652.
46. Liu YC, Ohyashiki JH, Ito Y, et al. Chlamydia psittaci in ocular adnexal lymphoma: Japanese experience. Leuk Res. 2006; 30(12): 1587-1589.