Treatment for MALT lymphomas is usually very successful. The treatment will depend on the type of MALT lymphoma you have and the stage it is at. If the lymphoma is growing very slowly and not causing any problems, you may not need any treatment for some time. Your doctor will monitor you closely so that if the lymphoma does start to grow, your treatment will be started.
MALT lymphoma of the stomach (gastric MALT lymphoma)
You will have tests to check for H. pylori infection. If this is present you’ll be given treatment called triple therapy to get rid of the infection. This involves taking a course of two antibiotics and an antacid treatment. Getting rid of H. pylori may clear all signs of the lymphoma (known as remission), although this may take several months. You’ll have regular endoscopies to check for signs of lymphoma in your stomach after your treatment.
If you don't have H. pylori, or if the lymphoma doesn't go away with triple therapy, or comes back, you may be offered one or more of the following treatments:
There is more information about these below.
Non-gastric MALT lymphoma
MALT lymphomas that start in other areas are usually treated with chemotherapy, radiotherapy or a monoclonal antibody therapy called rituximab. Surgery may be used to remove the lymphoma, depending on where it is and how widespread it is. Sometimes people who have MALT lymphoma in the tear gland of the eye, called a lacrimal MALT, may be given antibiotic treatment.
Chemotherapy is the use of anti-cancer (cytotoxic) drugs to destroy cancer cells. Chemotherapy for MALT lymphoma can usually be given as a tablet. Chlorambucil tablets are a commonly used type of chemotherapy. Other drugs that may also be used include cyclophosphamide, fludaribine and cladribine.
Monoclonal antibody therapy
Monoclonal antibodies are drugs that recognise, target and stick to specific proteins on the surface of cancer cells, and can stimulate the body’s immune system to destroy these cells. Rituximab is a monoclonal antibody that is given as a drip into a vein. It can be given with chemotherapy or, sometimes, on its own to treat MALT lymphoma.
Radiotherapy uses high-energy rays to destroy cancer cells, while doing as little harm as possible to normal cells. Radiotherapy is an effective treatment for MALT lymphoma of the stomach that hasn't spread to lymph nodes. It can also be used to treat early MALT lymphoma in some other parts of the body.
Occasionally, early MALT lymphomas that haven't spread may be removed with surgery.