From modern pathogenetic insights and molecular understanding to new deescalating therapeutic strategies in gastric MALT-lymphoma

Abstract

Based on new insights into the aetiology and pathogenesis of gastric marginal-zone B-cell lymphoma of MALT (MALT-lymphoma) and its histomorphological and molecular characteristics, important progress in our understanding of the disease and its clinical management has been made during the last decades. A landmark in this development was the identification of Helicobacter pylori as the decisive pathogenetic factor for gastric MALT lymphoma. We, here, give an overview about the history and the current knowledge of the histology, genetics, and molecular characteristics and pathogenesis of gastric MALT lymphoma. We then focus on how these findings have fundamentally changed its clinical management over the last three decades with consequent deescalating therapeutic strategies.

Zusammenfassung

Ausgehend von neuen Einsichten in die Ätiologie und Pathogenese gastraler Marginalzonen-B-Zell-Lymphome des MALT (MALT-Lymphome) und ihrer histomorphologischen und molekularen Charakteristika hat sich unser Verständnis der Erkrankung in den letzten Jahrzehnten erheblich verbessert und das klinische Management beeinflusst. Ein Meilenstein in dieser Entwicklung war die Entdeckung des Helicobacter pylori als entscheidender Risikofaktor für gastrale MALT-Lymphome. Wir präsentieren hier einen Überblick über die Geschichte und den aktuellen Kenntnisstand zu Histologie, Genetik, molekularen Charakteristika und Pathogenese der gastralen MALT-Lymphome. Danach fokussieren wir darauf, wie diese Erkenntnisse fundamental das klinische Management über die letzten drei Jahrzehnte verändert und konsequent zu deeskalierenden Therapiestrategien geführt hat.

Keywords

gastric MALT lymphoma - Helicobacter pylori - pathogenesis - histology - genetics - clinical management

Schlüsselwörter

Gastrale MALT-Lymphome - Helicobacter pylori - Pathogenese - Histologie - Genetik - klinisches Management

Publication History

Received: 25 April 2024

Accepted after revision: 02 August 2024

Article published online:
25 September 2024

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