Fax: (011) 34-93-2483343
Original Article
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†‡
Article first published online: 11 AUG 2009
DOI: 10.1002/cncr.24605
Copyright © 2009 American Cancer Society
Additional Information
How to Cite
Salar, A., Domingo-Domenech, E., Estany, C., Canales, M. A., Gallardo, F., Servitje, O., Fraile, G. and Montalbán, C. (2009), 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, 115: 5210–5217. doi: 10.1002/cncr.24605
- †
Presented at the 44th Annual Meeting of the American Society for Clinical Oncology, Chicago, Illinois, May 30-June 3, 2008.
- ‡
We thank Marta Pulido, MD, for editing the article and for editorial assistance.
Publication History
- Issue published online: 3 NOV 2009
- Article first published online: 11 AUG 2009
- Manuscript Accepted: 22 JAN 2009
- Manuscript Revised: 18 JAN 2009
- Manuscript Received: 4 NOV 2008
Funded by
- Instituto de Salud Carlos III
- Spanish Ministry of Science and Technology. Grant Number: PI07/0586
- Institut Municipal de Investigació Médica
- Hospital del Mar. Grant Number: ASS/2008
References
- 1, . Malignant lymphoma of mucosa associated lymphoid tissue. A distinctive type of B-cell lymphoma. Cancer. 1983; 52: 1410-1416.Direct Link:
- 2, , , et al. A revised European-American classification of lymphoid neoplasms: a proposal from the International Lymphoma Study Group. Blood. 1994; 84: 1361-1392.
- 3, , , et al. Distribution and incidence rates of lymphoid neoplasms according to the REAL classification in a single institution. A prospective study of 940 cases. Eur J Haematol. 1997; 59: 231-237.
- 4, , , et al. Extranodal marginal zone B cell lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma). In: Jaffe ES, Harris NL, Stein H, Vardiman JW, eds. World Health Organization Classification of Tumours. Pathology and Genetics of Tumours of Haematopoietic and Lymphoid Tissues. Lyon, France: IARC Press; 2001: 157-160.
- 5, , , et al. Mucosa-associated lymphoid tissue gastrointestinal and nongastrointestinal lymphoma behavior: analysis of 108 patients. J Clin Oncol. 1997; 15: 1624-1630.
- 6, , , et al. Nongastrointestinal low-grade mucosa-associated lymphoid tissue lymphoma: analysis of 75 patients. J Clin Oncol. 1999; 17: 1254-1258.
- 7, , , et al. Mucosa-associated lymphoid tissue lymphoma is a disseminated disease in 1 third of 158 patients analyzed. Blood. 2000; 95: 802-806.
- 8, , , et al. Regression of primary low-grade B-cell gastric lymphoma of mucosa-associated lymphoid tissue type after eradication of Helicobacter pylori. Lancet. 1993; 342: 575-577.
- 9, , , et al. Regression of primary gastric lymphoma of mucosa-associated lymphoid tissue type after cure of Helicobacter pylori infection. MALT Lymphoma Study Group. Lancet. 1995; 345: 1591-1594.
- 10, , , et al. Eradication of Helicobacter pylori infection in primary low-grade gastric lymphoma of mucosa-associated lymphoid tissue. Ann Intern Med. 1995; 122: 767-769.
- 11, , , et al. Gastric B-cell mucosa-associated lymphoid tissue (MALT) lymphoma. Clinicopathological study and evaluation of the prognostic factors in 143 patients. Ann Oncol. 1995; 6: 355-362.
- 12, , , . Role of surgery in patients with primary non-Hodgkin's lymphoma of the stomach: an old problem revisited. Br J Surg. 1993; 80: 1101-1106.Direct Link:
- 13, , , et al. Primary gastrointestinal non-Hodgkin's lymphoma: II. Combined surgical and conservative or conservative management only in localized gastric lymphoma-results of the prospective German Multicenter Study GIT NHL 01/92. J Clin Oncol. 2001; 19: 3874-3883.
- 14, , , et al. Stage I and II MALT lymphoma: results of treatment with radiotherapy. Int J Radiat Oncol Biol Phys. 2001; 50: 1258-1264.
- 15
- 16, , , et al. A clinical analysis of 2 indolent lymphoma entities: mantle cell lymphoma and marginal zone lymphoma (including the mucosa-associated lymphoid tissue and monocytoid B-cell subcategories): a Southwest Oncology Group study. Blood. 1995; 85: 1075-1082.
- 17, . Combination chemotherapy with cyclophosphamide, vincristine, and prednisone in advanced non-Hodgkin's lymphomas. Cancer. 1976; 37: 1275-1282.Direct Link:
- 18, , , et al. Efficacy of single agent chemotherapy in low-grade B-cell mucosa-associated lymphoid tissue lymphoma with prominent gastric expression. J Clin Oncol. 1995; 13: 2524-2529.
- 19, , , 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: 3872-3877.
- 20, , , et al. Efficacy of fludarabine and mitoxantrone (FN) combination regimen in untreated indolent non-Hodgkin's lymphomas. Ann Oncol. 2000; 11: 363-365.
- 21, , , et al. Treatment of extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) with mitoxantrone, chlorambucil and prednisone (MCP). Ann Oncol. 2003; 14: 1758-1761.
- 22, , , et al. Chlorambucil in combination with induction and maintenance rituximab is feasible and active in indolent non-Hodgkin's lymphoma. Br J Haematol. 2003; 123: 271-277.Direct Link:
- 23, , et al. 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; 23: 1979-1983.
- 24, , , et al. Rituximab for treatment of advanced extranodal marginal zone B cell lymphoma of the mucosa associated lymphoid tissue lymphoma. Oncology. 2003; 65: 306-310.
- 25, , , et al. Clinical activity of rituximab in extranodal marginal zone B-cell lymphoma of MALT type. Blood. 2003; 102: 2741-2745.
- 26, , , et al. Treatment of patients with low-grade B-cell lymphoma with the combination of chimeric anti-CD20 monoclonal antibody and CHOP chemotherapy. J Clin Oncol. 1999; 17: 268-276.
- 27, , , et al. CHOP chemotherapy plus rituximab compared with CHOP alone in elderly patients with diffuse large-B-cell lymphoma. N Engl J Med. 2002; 346: 235-242.
- 28, , . Fludarabine. An update of its pharmacology and use in the treatment of haematological malignancies. Drugs. 1997; 43: 1005-1037.
- 29, , , et al. Phase I and pharmacokinetic study of oral fludarabine phosphate in relapsed indolent B-cell non-Hodgkin's lymphoma. Ann Oncol. 2006; 17: 330-333.
- 30, , , et al. Phase II study of oral fludarabine phosphate in relapsed indolent B-Cell non-Hodgkin's lymphoma. J Clin Oncol. 2006; 24: 174-180.
- 31, , , et al. Pharmacokinetic study of single doses of oral fludarabine phosphate in patients with “low grade” non-Hodgkin's lymphoma and B-cell chronic lymphocytic leukemia. J Clin Oncol. 1999; 17: 1574-1579.
- 32
- 33, , , et al. Endoscopic ultrasonography in the local staging of primary gastric lymphoma. Endoscopy. 1993; 25: 502-508.
- 34, , , et al. Report on a workshop convened to discuss the pathological and staging classifications of gastrointestinal tract lymphoma. Ann Oncol. 1994; 5: 397-400.
- 35, , , et al. Report of an international workshop to standardize response criteria for non-Hodgkin's lymphomas. NCI-sponsored International Working Group. J Clin Oncol. 1999; 17: 1244-1253.
- 36, , , et al. Proposal for a new histological grading system for post-treatment evaluation of gastric MALT lymphoma [letter]. Gut. 2003; 52: 1656.
- 37Cancer Therapy Evaluation Program, National Cancer Institute. Common Toxicity Criteria. NCI-CTC version 3.0. Bethesda, Md: National Cancer Institute, 1998. Available at: http://ctep.cancer.gov/reporting/CTC-3.html. Accessed August 9, 2006.
- 38, , , . Persistent residual disease in t(11;18)(q21;q21) positive gastric mucosa-associated lymphoid tissue lymphoma treated with chemotherapy or rituximab. J Clin Oncol. 2005; 23: 7361-7362.
- 39, , , et al. Translocation t(11;18) (q21;q21) is not predictive of response to chemotherapy with 2CdA in patients with gastric MALT lymphoma. Oncology. 2004; 66: 476-480.
- 40, , , et al. Randomised phase 2 study of fludarabine with concurrent versus sequential treatment with rituximab in symptomatic, untreated patients with B-cell chronic lymphocytic leukemia: results from Cancer and Leukemia Group B 9712 (CALGB 9712). Blood. 2003; 101: 6-14.
- 41, , , et al. Rituximab chimeric anti-CD20 monoclonal antibody therapy for relapsed indolent lymphoma: half of patients respond to a 4-dose treatment program. J Clin Oncol. 1998; 16: 2825-2833.
- 42, , , et al. Opportunistic pulmonary infections with fludarabine in previously treated patients with low-grade lymphoid malignancies: a role for Pneumocystis carinii pneumonia prophylaxis. Am J Hematol. 1995; 49: 135-142.Direct Link:

1097-0142/asset/olbannerleft.gif?v=1&s=ca681f5719430b26e1bc15e9ea4c9fc0a7110104)
1097-0142/asset/olbannerright.gif?v=1&s=8142566facf7e76aef9be6c51162a2e920b3b9f9)
1097-0142/asset/cover.gif?v=1&s=a7299bc18f075294c232ade468773cd0672bd470)