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Marginal Zone B-cell Lymphoma; what should I do now?
May 26, 2003

Dear Dr Dezube

Following a biopsy I have been diagnosed with a low-grade B-cell lymphoma of MALT. CT scans have shown the lymphoma is limited to the nasopharynx and neck. I am HIV positive.

I believe the presentation is somewhat unusual and would welcome your advice.

Many thanks.

kelly

Response from Dr. Dezube

MALT lymphoma stands for mucosal associated lymphoid tissue. It is an unusual type of lymphoma, but certainly not rare. Most commonly it is found in the stomach and results from an infection caused by Heliobacter pylori. This is NOT the typical lymphoma which one sees in HIV-infected individuals. These lymphomas tend to be very slow growing (we call them indolent lymphomas). I would recommend that you have the pathology slides looked at again. This is a hard diagnosis to make and you want to be sure that this is indeed what you have. If the lymphoma can be encompassed in a radiation field, then often this lymphoma can be treated with radiation. More often than not, this lymphoma needs to be treated with chemotherapy. It typically responds very well, and the chemotherapy is usually well tolerated. Although many different regimens are used, I personally treat patients with CVP-R (cytoxan, vincristine, prednisone and rituxan). If you haven't had a bone marrow examination yet, you will need one. Good luck. Again, this is typically a cancer that is very treatable.


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