Extranodal marginal zone B-cell lymphoma of mucosa-associated lymphatic tissue (MALT)

Extranodal marginal zone B-cell lymphoma of mucosa-associated lymphatic tissue (MALT) is a type of indolent (slow-growing) non-Hodgkin lymphoma (NHL) that starts in B cells. It is also called MALT lymphoma.

MALT lymphoma belongs to a group of NHLs called marginal zone lymphomas, along with nodal marginal zone lymphoma (NMZL) and splenic marginal zone lymphoma (SMZL). They are called marginal zone lymphomas because they develop from the marginal zone, which is a specific area found in lymph nodes or the spleen.

MALT lymphoma develops in lymphatic tissue in the mucous membranes or tissues that line the body's organs and cavities.

Gastric MALT lymphoma starts in the stomach. Many people with gastric MALT lymphoma have a history of a bacterial infection caused by Helicobacter pylori (H. pylori). Other bacterial or viral infections are also linked to MALT lymphoma, such as hepatitis C virus.

Non-gastric MALT lymphoma starts in tissues and organs other than the stomach, such as the intestines, lungs, skin, salivary glands, thyroid, bladder, breasts or tissues around the eye. It is not linked to H. pylori, but it can develop in people with a history of certain autoimmune disorders.

Sometimes MALT lymphoma can change into an aggressive (fast-growing) type of NHL called diffuse large B-cell lymphoma (DLBCL). If it does, it is treated like DLBCL. Find out more about treatments for DLBCL.

Your healthcare team will suggest treatments based on your needs and work with you to develop a treatment plan.

If you have an H. pylori or hepatitis C virus (HCV) infection, you will be treated with antibiotics or antiviral drugs before you start cancer treatment. Treating H. pylori and HCV first can often clear the lymphoma completely and you may not need any more treatment.

If MALT lymphoma is developing slowly and not causing any symptoms, you may be offered watchful waiting. The healthcare team will do tests to carefully monitor the lymphoma. When symptoms appear or there are signs that the disease is progressing more quickly, they will offer other treatments.

Find out more about watchful waiting.

Radiation therapy uses high-energy rays or particles to destroy cancer cells. It may be used to treat MALT lymphoma that is in specific areas of the body, such as the stomach or the lungs.

Find out more about radiation therapy for NHL.

Targeted therapy uses drugs to target specific molecules (such as proteins) on cancer cells or inside them. These molecules help send signals that tell cells to grow or divide. By targeting these molecules, the drugs stop the growth and spread of cancer cells while limiting harm to normal cells. Targeted therapy may also be called molecular targeted therapy.

Rituximab (Rituxan and biosimilars) is a targeted therapy drug used to treat MALT lymphoma. It can be used alone or with chemotherapy.

Find out more about targeted therapy for NHL.

Chemotherapy uses drugs to destroy cancer cells. You may be offered chemotherapy for MALT lymphoma. It can be combined with the targeted therapy drug rituximab.

The most common drugs or drug combinations used to treat MALT lymphoma are:

• chlorambucil (Leukeran)
• bendamustine (Treanda, Benvyon, Esamuze)
• fludarabine (Fludara)
• CVP – cyclophosphamide (Procytox), vincristine and prednisone
• CHOP – cyclophosphamide, doxorubicin, vincristine and prednisone

Find out more about chemotherapy for NHL.

Talk to your doctor about clinical trials open to people with NHL in Canada. Clinical trials look at new ways to prevent, find and treat cancer. Find out more about clinical trials.