Gastric MALT Lymphomas Prospective LY03 Randomized Cooperative Trial: Preliminary Results of the Molecular Follow-up

Reviewer: William Levin, MD
The Abramson Cancer Center of the University of Pennsylvania
Last Modified: December 10, 2001

Presenter: F. Bertoni
Presenter's Affiliation: Barts and The London, London
Type of Session: Scientific


  • Gastric MALT lymphoma is most commonly treated with antibiotic therapy directed at H. Pylori infection.
  • Previous studies have shown that eradication of H. pylori can cause complete regression of gastric MALTs.
  • In the current study, investigators wanted to know if the addition of chlorambucil chemotherapy is of benefit after completion of antibiotic therapy.

    Materials and Methods

  • All patients with gastric MALT lymphoma received antibiotic therapy.
  • Following treatment, all pts underwent endoscopy and biopsy.
  • Tissue biopsies were not only reviewed histologically, but also by molecular analysis (polymerase chain reaction).
  • Pts with a histologic CR were randomized to receive either chlorambucil or observation.


  • 46 of 62 pts (74%) had a histologic CR.
  • Follow-up material was available for molecular analysis in 34 cases.
  • 13 were randomized to chlorambucil, 11 to observation, and 10 had not been randomized.
  • 14 patients failed to achieve a molecular CR.
  • One year after histologic CR, 17 pts were in mCR and 3 achieved mCR by 2 years.
  • At a median follow-up at 2 years, 14(41%) of pts are in mCR.
  • For the pts randomized to chlorambucil, 46%(6/13) achieved mCR, versus 82%(9/11) in the control group.
  • Molecular relapse was seen in 17% of pts in the chlorambucil group and 44% in the observation group.

    Author's Conclusions

  • Less than half of pts with gastric MALT are able to achieve a continuous molecular CR after antibiotic therapy.
  • The addition of chlorambucil to standard therapy does not appear to have a benefit.

    Clinical/Scientific Implications

  • Molecular techniques may offer a more sensitive assessment of post-treatment therapy.
  • More effective therapies are needed in the treatment of gastric MALT lymphoma.

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