Rituximab Plus Lenalidomide in Patients With Mucosa Associated Lymphoid Tissue

Inclusion Criteria selected: * Histologically verified diagnosis if MALT lymphoma of any localization * Measurable disease upon diagnosis or first or greater relapse after local therapy, prior chemotherapy orHP-eradication. In addition, also in patients with gastric MALT-lymphoma judged refractory to HP-eradication by a minimum follow-up of 12 months after successfulHP-eradication will be included in the study. Patients with gastric MALT lymphoma and no evidence of HP-infection may be enrolled immediately * Ann Arbor Stage I-IV * In case of prior treatment with Rituximab, the presence of CD20 on lymphoma cells must have been demonstrated before inclusion in the trial. * ECOG performance status of 0,1 or 2 * Patient must be able to take aspirin daily as prophylactic anticoagulation (patients intolerant to ASA may use warfarin or low molecular weight heparin Exclusion Criteria selected: * Lymphoma histology other than MALT lymphoma or MALT lymphoma with a diffuse large cell lymphoma ("high grade lymphoma") - component * Use of any investigational agent within 28 days prior to initiation of treatment with lenalidomide * History of malignancy other than squamous cell carcinoma, basal cell carcinoma of the skin or carcinoma in situ of the cervix within the last 5 years * Major surgery, other than diagnostic surgery, within the last 4 weeks * Evidence of CNS involvement * A history of uncontrolled seizures, central nervous system disorders or psychiatric disability judged by the investigator to be clinically significant and adversely affecting compliance to study drugs * Severe peripheral polyneuropathy * Clinically significant cardiac disease or myocardial infarction within the last 6 months * Known hypersensitivity to thalidomide or lenalidomide or rituximab