This low grade non-Hodgkin lymphoma (NHL) starts in the mucosa which lines some body organs and cavities.
MALT lymphoma belongs to a group of non-Hodgkin lymphomas called marginal zone lymphomas.
What is lymphoma?
Lymphoma is cancer of the lymphatic system.
The lymphatic system is a network of thin tubes and lymph nodes that run throughout the body. Lymph nodes are bean shaped glands. The thin tubes are called lymph vessels or lymphatic vessels. Tissue fluid called lymph circulates around the body in these vessels and flows through the lymph nodes. The lymph contains a high number of white blood cells (lymphocytes) which fight infection.
When you have lymphoma, some of your lymphocytes don't work properly. They start to divide constantly but don't develop fully. So they can't fight infection as normal white blood cells do.
What is MALT lymphoma?
MALT stands for mucosa associated lymphoid tissue.
The mucosa is the moist tissue that lines some organs and body cavities, including the nose, mouth, lungs, and digestive tract. So MALT lymphoma starts in the body organs, and not in the lymph nodes.
There are 2 main types of lymphocytes:
- B cells
- T cells
MALT lymphoma starts in the B cells, so it is a B cell lymphoma.
These low grade (indolent) lymphomas are most often diagnosed in the stomach (called gastric MALT). But they can also develop in the lung, thyroid, salivary glands, eye, skin or soft tissues (called non gastric MALT).
MALT lymphoma usually grows slowly. Most people have early stage (localised) MALT lymphoma when they are diagnosed. The outlook is good, even when the lymphoma is quite widespread.
Your symptoms depend on where the MALT lymphoma starts.
Indigestion or heartburn are the most common symptoms of MALT lymphoma that starts in the stomach. Some people also lose weight, feel or are sick, and have pain in the tummy (abdomen).
Who gets it
MALT lymphoma is most often diagnosed in older people.
Many people diagnosed with MALT lymphoma of the salivary gland have had an autoimmune disease called Sjogren’s syndrome. And people with MALT lymphoma of the thyroid may have had a condition of the thyroid called Hashimoto’s thyroiditis.
MALT is a low grade lymphoma and treatment usually works well.
The type of treatment you have for low grade (indolent) NHL depends on:
- the stage of your lymphoma when it is diagnosed
- the symptoms you have at the time
- your general health and fitness
Treatment for stomach (gastric) MALT
Most cases of MALT lymphoma of the stomach are linked to a chronic stomach infection caused by the bacteria Helicobacter pylori. This infection causes inflammation of the stomach lining, with symptoms of indigestion and stomach pain.
Treatment and follow up
MALT lymphoma of the stomach is treated with antibiotics. They are very successful at shrinking the lymphoma. But we don’t yet know if this is a permanent cure. So your doctor keeps a close eye on you for some years after successful treatment.
You have an endoscopy about 3 to 6 months after the antibiotic treatment has finished. This is to make sure the lymphoma has not come back. You might have regular endoscopies for a while after that.
Treatment for non gastric MALT
You usually have low doses of radiotherapy to the area of the lymphoma.
In some people, the MALT has spread to nearby lymph nodes or, less often, to another body organ when it is diagnosed. You might have chemotherapy with immunotherapy (chemoimmunotherapy).
The most common treatments include:
- rituximab (immunotherapy) with bendamustine
- rituximab with CVP (a combination of cyclophosphamide, vincristine, and dexamethasone)
- chlorambucil (chemotherapy)
The best person to talk to you about your outlook or prognosis is your doctor. Not everyone wants to know, people cope differently with their lymphoma and want different information.
Survival depends on many factors. So no one can tell you exactly how long you will live. Your doctor might be able to give you some guide, based on their knowledge and experience.
Research and clinical trials
Your doctor might ask if you’d like to take part in a clinical trial. Doctors and researchers do trials to:
- make existing treatments better
- develop new treatments
Cancer Research UK nurses
Coping with NHL
Advice and support is available to help you cope with NHL and its treatment.