Doctors at the Ichilov Medical Center are often recognized specialists in hematology and oncology with deep knowledge and experience in combating various forms of lymphoma. The treatment of bronchus-associated lymphoid tissue lymphoma (BALT lymphoma) in Israel employs advanced medical technologies and treatment methods, including the latest protocols for chemotherapy, targeted therapy, and immunotherapy.
Treatment at Ichilov Clinic is based on a carefully tailored individual plan for each patient, based on their unique clinical picture. Multidisciplinary teams of specialists include oncologists, hematologists, radiologists, pathologists, and doctors from other fields.
Patients at Ichilov have access to the latest medications or therapeutic methods that are not always available in other medical centers. Patients are guaranteed a high standard of care, including psychological and informational support, rehabilitation programs to accelerate recovery, and a comprehensive range of services for international patients.
About the Disease
Bronchus-associated lymphoid tissue lymphoma (BALT lymphoma) is classified as an extranodal marginal zone lymphoma and is a rare subtype of non-Hodgkin lymphoma. It arises from lymphoid tissue associated with the bronchi, which is part of the local immune response of the respiratory tract.
The exact causes of BALT lymphoma are not established, but chronic inflammation is believed to play a key role. Several studies link the disease to chronic infectious processes, including infections caused by Helicobacter pylori, Chlamydophila psittaci, and Epstein-Barr virus. Additionally, the presence of autoimmune diseases such as rheumatoid arthritis and Sjögren's syndrome also increases the risk of developing BALT lymphoma.
The most characteristic symptoms of BALT lymphoma may be nonspecific and include:
- cough,
- shortness of breath,
- chest pain,
- obstructive symptoms of the airways,
- recurrent respiratory infections.
In some cases, asymptomatic BALT lymphoma is incidentally detected on chest X-rays taken for other reasons.
Treatment Methods for the Disease
Bronchus-associated lymphoid tissue lymphoma (BALT lymphoma) is a rare form of non-Hodgkin lymphoma. At Ichilov Clinic, the treatment program for each patient is developed individually, taking into account many factors, including the stage, overall health, age, and characteristics of the disease progression.
Chemotherapy
Chemotherapy in the treatment of BALT lymphoma is a central element of a comprehensive approach to treating this type of disease. The method is based on the use of antineoplastic (anti-tumour) compounds. They specifically target cancer cells, slowing their growth or destroying them. Various anticancer drugs are used in chemotherapy, which are selected individually.
Monoclonal Antibody Therapy
The use of monoclonal antibodies in the treatment of BALT lymphoma is a technique that employs biotechnologically developed drugs. The task of these agents is to mimic the natural antibodies of the immune system and specifically target certain antigens on cancer cells.
In the context of treating BALT lymphoma, the drug most commonly used targets the CD20 antigen. It is present on the surface of B cells, including cancerous ones, characteristic of non-Hodgkin forms, including BALT lymphoma. The goal of binding the monoclonal antibody to CD20 is to activate mechanisms for destroying lymphoma cells, including cell-mediated cytotoxicity and apoptosis.
Monoclonal antibody therapy can be administered either as a monotherapy or in combination with chemotherapy.
Treatment with monoclonal antibodies is one form of immunotherapy aimed at mobilizing the body's natural defenses to fight cancer cells. At the same time, this method can also be considered part of targeted therapy, as it targets a specific biomarker or target on cancer cells.
Radiotherapy
The goal of the method is to destroy cancer cells and prevent their further spread. At Ichilov Clinic, precise irradiation is practiced specifically on those areas of the lungs or airways where lymphoid nodes and other affected tissues have been found. Radiotherapy can be used as a standalone treatment method or as part of a comprehensive therapy in combination with chemotherapy and monoclonal antibodies.
Ichilov uses modern TrueBeam and Lunac linear accelerators – advanced equipment for precision radiotherapy. They provide high accuracy, real-time visualization of the process, and modulated beam intensity. With this equipment, both stereotactic radiosurgery (SRS) and stereotactic body radiation therapy (SBRT) can be performed, significantly optimizing the prognosis for targeted treatment of small tumours, including some types of BALT lymphoma.
Surgical Intervention
Surgical treatment of BALT lymphoma may be appropriate in cases where the disease is limited to a local area and the tumour is accessible for removal without serious damage to surrounding tissues. Surgery may be recommended if the tumour exerts pressure on nearby organs or structures, causing discomfort or pain, or provokes other complications.
At Ichilov Clinic, various surgical approaches are applied, depending on the size, location of the tumour, and the overall health of the patient:
- thoracotomy – open surgical intervention with extended access to the thoracic cavity. Suitable for large or difficult-to-locate tumours;
- video-assisted thoracoscopic surgery – a less invasive approach through small incisions using video equipment and mini instruments;
- lobectomy – removal of one or more lobes of the lung if the tumour is located within one lobe;
- segmentectomy – removal of the part of the lung that contains the tumour and a small volume of healthy tissue around it.
Robotic-assisted systems, such as Da Vinci, allow for surgeries to be performed with high precision and control, using minimally invasive methods.
Targeted Therapy
This method involves the targeted impact on specific molecular targets that play a key role in the growth and development of cancer cells. This treatment differs from traditional chemotherapy due to less damage to normal cells.
Targeted therapy is based on drugs that can block or suppress signaling pathways and processes specific to cancer cells. These can be various molecules, including monoclonal antibodies and small molecules that interact with specific molecular structures within cancer cells.
Immunotherapy
Immunotherapy is a modern method of treating BALT lymphoma that involves stimulating or modifying the patient's immune system to fight cancer cells. Unlike traditional chemotherapy, which aims to destroy actively dividing cells, immunotherapy works with the immune system, helping it recognize and effectively attack cancer.
This method includes multiple directions:
- immune checkpoint inhibitors;
- immunomodulators;
- cell therapy.
Steroids
The effectiveness of this method depends on specific clinical circumstances. Corticosteroids are powerful anti-inflammatory drugs that affect the immune response and have anti-tumour effects on some types of lymphomas.
As part of comprehensive treatment, steroids can be used in combination with chemotherapy or immunotherapy to enhance the overall effect, especially in the presence of inflammation caused by the tumour.
Stem Cell Transplantation
In cases, especially when the disease is resistant to standard therapy methods or when a relapse occurs, stem cell transplantation may help. There are two main types of the procedure:
- autologous, involving the use of the patient's own stem cells;
- allogeneic, where cells from a donor are used.
- Stem cell treatment
- Radiotherapy
- Chemotherapy
Methods of Diagnosing the Disease
The diagnosis of bronchus-associated lymphoid tissue lymphoma (BALT lymphoma) is confirmed comprehensively and includes several stages. Typically, it takes 3 working days to collect samples and process research results.
First Day
Collection of detailed medical and family history of the patient. Examination of the patient for symptoms such as lymph node enlargement and other clinical signs.
Second Day
Laboratory studies:
- complete blood count to detect anemia or other abnormalities;
- biochemical blood test, including liver function tests and LDH (lactate dehydrogenase);
- serological tests to identify potential infections that may contribute to the development of BALT lymphoma.
Instrumental studies:
- chest X-ray to identify visible lung or mediastinal abnormalities;
- computed tomography (CT) of the chest;
- positron emission tomography (PET) combined with CT (PET-CT) to determine the extent of the process;
- bronchoscopy with biopsy to obtain tissue samples from the bronchi or lungs for histological examination.
Histological and immunohistochemical analysis:
- morphological analysis of tissue samples obtained from biopsy;
- immunohistochemical studies to determine the phenotypic characteristics of the cells, which is a key factor for accurate classification of the lymphoma.
Third Day
The diagnostic process involves a team including: a therapist or pulmonologist, oncologist, radiologist, hematologist, and other specialists. Quality diagnosis of BALT lymphoma at Ichilov Clinic is based on close interaction among all members of the collegial group, ensuring accurate determination of the type of disease, stage, and selection of treatment methods.
- Biopsy
- Computed Tomography
- Diagnosis – PET CT
- X-ray
- Blood Biochemistry
How Much Does Treatment Cost
The cost of treating BALT lymphoma at the Ichilov clinic in Israel may depend on many factors. Complex cases usually require more intensive treatment. The price is influenced by the types of treatment, duration and complexity of procedures, and the need for additional tests and consultations.
Contact the medical coordinator to find out how much a hospital stay costs, how to arrange accommodation for a companion, and where to find transport and reviews. You can ask any questions by phone or through the online bot. The website also provides a special feedback form.
Advantages of Treating Bronchus-Associated Lymphoid Tissue Lymphoma (BALT Lymphoma) in Israel
- High level of medical expertise and innovative treatment methods
- Individual treatment plan under the guidance of a multidisciplinary team of doctors
- Access to the latest methods and medications
- Comprehensive rehabilitation programs
- Support for international patients
The quality and safety of medical services and patient orientation make Ichilov Clinic well-known far beyond the borders of Israel. Today, you can order a video consultation with a leading specialist in the treatment of rare forms of non-Hodgkin lymphoma without leaving your country. Via Zoom or Skype, the doctor will assess the current condition based on available studies and provide a preliminary prognosis and recommendations for further actions.