Complete response to fludarabine in a patient with multifocal gastrointestinal MALT lymphoma (Meeting abstract). NLM AIDSLINE Important note: Information in this article was accurate in 1997. The state of the art may have changed since the publication date.

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Complete response to fludarabine in a patient with multifocal gastrointestinal MALT lymphoma (Meeting abstract).

Proc Annu Meet Am Soc Clin Oncol; 16:A1066 1997. Unique Identifier : AIDSLINE MED/97621091
Neuman J; Ray D; Mehta K; Gruber T; Aquino M; Monmouth Medical Center, Long Branch, NJ

Abstract: Mucosa associated lymphoid tissue (MALT) lymphoma is an extranodal non-Hodgkin's B-Cell lymphoma usually localized to a specific tissue in a given patient. Sites of tissue involvement may include the gastrointestinal tract (usually the stomach), salivary glands, thyroid, thymus, lung, liver, orbital tissue, conjunctiva, breast, kidney, urinary bladder and skin. Gastric MALT lymphomas associated with H. pylori have been reported to resolve with antibiotic therapy alone. A 35 year old man presented with a four year history of intermittent abdominal pain, gastrointestinal hemorrhage, nausea and anorexia unrelieved by antacids. He also had a one year history of fatigue, night sweats and iron deficiency anemia; his body weight had been stable. Upper and lower endoscopies one year prior to diagnosis revealed only internal hemorrhoids. Upper endoscopy revealed nodularity of the duodenal bulb. Colonoscopy revealed multifocal nodularity. Histologic examination of the biopsies of the stomach and small and large intestine revealed gastrointestinal epithelium infiltrated by a diffuse lymphoid infiltrate with slightly irregular nuclei. Lymphoepithelial lesions were identified. Flow cytometry analysis of fresh specimens revealed that approximately 30-35% of the lymphoid cells were B-cells and expressed CD19, CD20, CD22 and HLA-DR. These lymphoid cells were negative for surface immunoglobulins and failed to express CD23. A diagnosis of low grade B-cell lymphoproliferative disorder, MALT lymphoma was made. H pylori was positive by both CLO-test and serology (IgA and IgG). HIV testing was negative. A CT scan of the chest, abdomen and pelvis revealed only thickening of the ileocecal valve. Bone marrow biopsy was non-definitive. The patient was treated with a 3 week course of clarithromycin, tetracycline, bismuth and omeprazole with some improvement of symptoms but with endoscopic and pathologic persistence of MALT lymphoma. Repeat upper endoscopy and colonoscopy after six cycles of fludarabine 25 mg/m2 revealed complete clinical and pathological remission. (C) American Society of Clinical Oncology 1997
Keywords: *Antineoplastic Agents/THERAPEUTIC USE *Intestinal Neoplasms/DRUG THERAPY *Lymphoma, Mucosa-Associated Lymphoid Tissue/DRUG THERAPY *Vidarabine/ANALOGS & DERIVATIVESKWDantineoplasticagents/therapeuticuseKWDintestinalneoplasms/drugtherapyKWDlymphoma,mucosa-associatedlymphoidtissue/drugtherapyKWDvidarabine/analogs&derivatives
971130
M97B1213

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