Treatment of several special types of lymphoma

Treatments for specific types of lymphoma include:

1. Indolent nodal primary NHL

Stage II grade I and II follicular lymphoma progresses slowly, and radiotherapy alone can achieve good results. The treatment plan for stage III and IV patients is: if the condition is stable and does not affect the quality of life and the function of major organs, you can wait and observe. Otherwise, chemotherapy should be performed. In general, COPP or CHOP regimens are sufficient. Chemotherapy combined with interferon treatment can improve the efficacy. For CD20+ relapse and drug resistance, anti-CD20 monoclonal antibodies are available. Autologous and allogeneic hematopoietic stem cell transplantation has also been used in the treatment of this type of NHL. In recent years, a new trend is the use of non-myeloid allogeneic hematopoietic cell transplantation (mini-transplant) in such patients, and the initial results are satisfactory.

MALT-type lymphoma can occur in the gastrointestinal tract, salivary glands, lacrimal glands, Waldeyer's ring, thyroid gland, pharynx, trachea, pleura, kidney, connective tissue and bladder. Most of them are localized and progress slowly. They are low-grade malignant B-cell lymphomas with unique histological characteristics, immunophenotypes and genotypes. Currently, local treatment is the main treatment. Surgical resection with or without radiotherapy and chemotherapy can achieve satisfactory results for patients, with a 5-year survival rate of 80% to 90%.

Gastric MALT-type lymphoma can regress after anti-Helicobacter pylori treatment. The current consensus is that effective antibacterial treatment and endoscopic follow-up should be performed first. Other treatment methods should be considered only when antibacterial treatment is ineffective or fails. Surgical resection of the primary lesion is the most commonly used method, supplemented by local radiotherapy after surgery.

3. Mantle cell lymphoma

It is a new pathological type listed in the Real classification and the WH02000 classification. This type of lymphoma originates from B cells in the follicular mantle layer. Translocation is the characteristic of this disease. Multiple sites are affected at the time of diagnosis, and the biological behavior is moderately invasive.