Effects of Helicobacter pylori Eradication on Early Stage Gastric Mucosa–Associated Lymphoid Tissue Lymphoma

Zullo, Angelo; Hassan, Cesare; Cristofari, Francesca; Andriani, Alessandro; Francesco, Vincenzo De; Ierardi, Enzo; Tomao, Silverio; Stolte, Manfred; Morini, Sergio; Vaira, Dino

doi:10.1016/j.cgh.2009.07.017

Cited by 253 publications

(212 citation statements)

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“…Because it is a rare disease, there are no prospective randomized trials to assess the effect of H pylori eradication in gastric MALT lymphoma remission. A recent systematic review evaluating 32 studies involving 1,408 patients with low-grade MALT lymphoma showed the presence of H pylori infection in 88.2% of cases and complete remission of the tumor just by eradicating the bacteria in over 75% of cases (214) . A recent consensus meeting acknowledges H pylori eradication to be a first line treatment for gastric MALT lymphoma (177) .…”

Section: Statement 11mentioning

confidence: 99%

3rd BRAZILIAN CONSENSUS ON Helicobacter pylori

Coelho

Maguinilk

Zaterka³

et al. 2013

Arq. Gastroenterol.

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Significant progress has been obtained since the Second Brazilian Consensus Conference on Helicobacter pylori Infection held in 2004, in São Paulo, SP, Brazil, and justify a third meeting to establish updated guidelines on the current management of H. pylori infection. The Third Brazilian Consensus Conference on H pylori Infection was organized by the Brazilian Nucleus for the Study of Helicobacter, a Department of the Brazilian Federation of Gastroenterology and took place on April 12-15, 2011, in Bento Gonçalves, RS, Brazil. Thirty-one delegates coming from the five Brazilian regions and one international guest, including gastroenterologists, pathologists, epidemiologists, and pediatricians undertook the meeting. The participants were allocated in one of the five main topics of the meeting: H pylori, functional dyspepsia and diagnosis; H pylori and gastric cancer; H pylori and other associated disorders; H pylori treatment and retreatment; and, epidemiology of H pylori infection in Brazil. The results of each subgroup were submitted to a final consensus voting to all participants. Relevant data were presented, and the quality of evidence, strength of recommendation, and level of consensus were graded. Seventy per cent and more votes were considered as acceptance for the final statement. This article presents the main recommendations and conclusions to guide Brazilian doctors involved in the management of H pylori infection.

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Section: Statement 11mentioning

confidence: 99%

3rd BRAZILIAN CONSENSUS ON Helicobacter pylori

Coelho

Maguinilk

Zaterka³

et al. 2013

Arq. Gastroenterol.

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“…The standard eradication of H. pylori using protonpump inhibitors, clarithromycin and amoxicillin, is established as the first-line therapy for gastric MALT lymphomas in H. pylori-infected patients, and previous reports have described that the remission rate is around 80% (Zullo et al 2010;Gisbert and Calvet 2011). However, there have been some reports regarding factors related to the resistance to eradication therapy in H. pylori-positive gastric MALT lymphomas, and one of them is t(11;18)(q21;q21) chromosomal translocation (Nakamura et al 2008;Zullo et al 2010).…”

mentioning

confidence: 99%

Eradication Therapy Is Effective for <i>Helicobacter pylori</i>-Negative Gastric Mucosa-Associated Lymphoid Tissue Lymphoma

Asano

Iijima

Terai

et al. 2012

Tohoku J. Exp. Med.

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Mucosa-associated lymphoid tissue (MALT) lymphomas are extra-nodal B-cell lymphomas arising from MALT, and the most commonly affected organ is the stomach. Helicobacter pylori (H. pylori) eradication therapy with proton-pump inhibitors and antibiotics is the first-line therapy for H. pylori-positive gastric MALT lymphomas, but the effectiveness of the therapy for H. pylori-negative gastric MALT lymphomas remains controversial. Hence, we aimed to evaluate the effectiveness of this eradication therapy for H. pylorinegative MALT lymphomas. The H. pylori infection status of 158 gastric MALT lymphoma patients followed in our unit was judged by urea breath test, rapid urease test, histology of the biopsy specimen taken from the stomach during endocopy, and serum antibody against H. pylori. Seventeen patients that were negative for all four tests and did not have gastric mucosal atrophy were treated with antibiotic eradication therapy. The average age at diagnosis was 56.8 years old (range: 36-73 years), and the median follow-up period after H. pylori eradication in all 17 patients was 5.3 years (range: 0.3-12.7 years). Five patients (29.4%) achieved complete remission (CR) by eradication therapy alone. Comparison between the responding and non-responding patients revealed that the patients endoscopically diagnosed to have a single lesion of gastric MALT lymphoma were seen only in the responding group, whereas all non-responding patients had multiple lesions (P < 0.05). In conclusion, H. pylori eradication therapy achieved a favorable CR rate in H. pylori-negative gastric MALT lymphoma patients and could be considered as a first-line therapy, especially for patients with a single lesion.

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“…However, CR criteria varied among those studies. In a systematic review of 32 reports including those listed above,23 CR was found to have been achieved in 77% (1091/1408). The present study showed a high CR rate of 86.6% using H. pylori eradication therapy alone.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have identified several factors associated with eradication resistance, including t(11;18)(q21;q21)/ API2–MALT1 translocation, absence of H. pylori infection, advanced clinical stage, deep submucosal invasion, and proximal localization in the stomach 15, 23, 24, 25. In this study, only 1 patient was positive for t(11;18)(q21;q21)/ API2–MALT1 translocation, all patients were H. pylori ‐positive, 98% (95/97) showed stage I MALT lymphoma, and 10% (10/97) exhibited invasion beneath the submucosa.…”

Section: Discussionmentioning

confidence: 99%

Anti‐Helicobacter pylori therapy in localized gastric mucosa‐associated lymphoid tissue lymphoma: A prospective, nationwide, multicenter study in Japan

et al. 2018

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Background Helicobacter pylori eradication therapy was approved in Japan for the first‐line, standard treatment of H. pylori‐positive gastric mucosa‐associated lymphoid tissue (MALT) lymphoma. Although several retrospective studies or small‐scale single‐center studies have been reported, a prospective, large‐scale, nationwide, multicenter study has not been reported from Japan.Materials and MethodsWe conducted a prospective, nationwide, multicenter study to evaluate the clinical efficacy of rabeprazole‐based triple H. pylori eradication therapy for patients with localized gastric MALT lymphoma in practice‐based clinical trial. A total of 108 H. pylori‐positive patients with stage I/II 1 gastric MALT lymphoma underwent H. pylori eradication therapy. The primary endpoints were complete remission (CR) rate and the rate of transfer to secondary treatment. The secondary endpoints were CR maintenance duration and overall survival (OS).Results CR of lymphoma was achieved in 84 of 97 patients (86.6%), during the period 2.0‐44.7 months (median, 5.3 months) after starting H. pylori eradication treatment. CR was maintained in 77 of 81 patients (95.1%) for 0.4‐53.2 months (median, 33.1 months). Secondary treatments (radiotherapy, rituximab, or gastrectomy) for gastric MALT lymphoma were needed in 10 of the 97 patients (10.31%). During follow‐up, OS rate was 96.9% (94/97) and the causes of 3 deaths were not related to lymphoma.ConclusionsRabeprazole‐based H. pylori eradication therapy demonstrated a high CR rate, long CR maintenance, and a good OS for patients with localized gastric MALT lymphoma in this prospective, practice‐based, multicenter study.

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Effects of Helicobacter pylori Eradication on Early Stage Gastric Mucosa–Associated Lymphoid Tissue Lymphoma

Abstract: H pylori eradication is effective in treating approximately 75% of patients with early stage gastric lymphoma. Long-term follow-up evaluation of these patients is needed to detect early lymphoma relapse or progression.

Cited by 253 publications

References 50 publications

3rd BRAZILIAN CONSENSUS ON Helicobacter pylori

3rd BRAZILIAN CONSENSUS ON Helicobacter pylori

Eradication Therapy Is Effective for <i>Helicobacter pylori</i>-Negative Gastric Mucosa-Associated Lymphoid Tissue Lymphoma

Anti‐Helicobacter pylori therapy in localized gastric mucosa‐associated lymphoid tissue lymphoma: A prospective, nationwide, multicenter study in Japan

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