THERAPEUTIC APPROACH OF PRIMARY GASTROINTESTINAL LYMPHOMA

Primary gastrointestinal lymphoma (Maltoma) represent between 1 to 4 % of all gastrointestinal malignancies. Disseminated cases are hard to differentiate with advanced stages of peripheral non-Hodgkin's lymphoma. The discovery of specific adhesion molecules could resolve this physiopathological problem. The prevalence of small bowel lymphoma is higher in Middle-East and South Africa (50 % vs 30 %) than in West Europa because of the occurence of the immunoproliferative small intestinal disease (IPSID). Pluricentric locations and disseminated forms of small bowel lymphoma yield curative surgery uneasiness. An algorithm of treatment, including surgery, mono or polychemotherapy, colony-stimulating factors, and interferon, taking into account histological and clinical stages is proposed. Because of the rarity of the disease, treatment must be improved by activation of international pluricentric randomized trials.