胃と腸49巻5号

2014年05月発行

増刊号 消化管悪性リンパ腫2014 主題 消化管原発low-grade lymphoma―MALTリンパ腫

胃MALTリンパ腫の診断と治療―治療

著者： 川添彬人¹ 山田遥子¹ 土井俊彦¹

所属機関： ¹国立がん研究センター東病院消化管内科

ページ範囲：P.616 - P.622

近年，胃MALTリンパ腫に対するH. pylori除菌療法の高い奏効率と良好な長期成績が報告されている．H. pylori陰性，t（11 ; 18）/API2-MALT1転座例では寛解率が低いが，除菌による寛解例が報告されていることから，低侵襲である除菌治療をまず試みるのが一般的である．一方，進行期はまれで治療に関するエビデンスに乏しいため，現在は低悪性度B細胞リンパ腫である濾胞性リンパ腫と同様の治療方針がとられる．低腫瘍量の場合にはwatch and waitを行い，高腫瘍量の場合はリツキシマブと化学療法の併用，またはシクロホスファミド単独経口投与が有効な治療法となる．最近ではR-chlorambucil療法やR-bendamustine療法も注目されている．

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