Relapse of Low-Grade Gastric MALT Lymphoma After Helicobacter Pylori Eradication: True Relapse or Persistence? Long-Term Post-Treatment Follow-Up of a Multicenter Trial in the North-East of Italy and Evaluation of the Diagnostic Protocol’s Adequacy

Savio, Antonella; Valli, M.; Zamboni, Giuseppe; Capelli, Paola; Scarpa, Aldo; Mombello, Aldo; Franzin, G.; Negrini, Riccardo; Santandrea, Giuseppe; Pascarella, Anna; Fuini, A.; Pasini, Felice; Ambrosetti, Achille; Paterlini, A; Buffoli, Federico; Cesari, P.; Rolfi, F.; Graffeo, M; Angelini, G.; Ederle, A.

doi:10.1007/978-3-642-57054-4_15

Cited by 55 publications

(34 citation statements)

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“…In the update of the multicentre study of Fischbach et al (2004) comprising 90 patients, 4.4% relapsed after a median follow-up of 44 months. In another Italian series of Savio et al (2000) involving 76 patients, 8% recurred during a median follow-up of 28 months. Our study showed that MALT lymphoma recurred in 6.0% of patients with a median follow-up of 41 months.…”

Section: Discussionmentioning

confidence: 95%

“…The disease recurrence rate has been reported to vary from 7 to 12.5% in patients who once achieved CR Savio et al, 2000;Stolte et al, 2002;Fischbach et al, 2004). In the update of the multicentre study of Fischbach et al (2004) comprising 90 patients, 4.4% relapsed after a median follow-up of 44 months.…”

Section: Discussionmentioning

confidence: 99%

“…Recently, Helicobacter pylori eradication is considered wellaccepted initial therapy in cases of localised (stage I) low-grade gastric mucosa-associated lymphoid tissue (MALT) lymphoma, in which recently published series confirmed 62 -95% complete remission (CR) rate Savio et al, 2000;Montalban et al, 2001;Fischbach et al, 2004;Wundisch et al, 2005). The variation of CR rates may be due to the heterogeneity of previous studies, particularly as regards of study design and clinical characteristics.…”

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Helicobacter pylori eradication for low-grade gastric mucosa-associated lymphoid tissue lymphoma is more successful in inducing remission in distal compared to proximal disease

et al. 2007

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A series of studies has shown that Helicobacter pylori eradication induces remission in most patients with low-grade gastric mucosaassociated lymphoid tissue (MALT) lymphoma. However, there have been few reports about the effect of bacterial treatment on the gastric MALT lymphoma in Korea, a well-known H. pylori endemic area. A total of 111 H. pylori-infected patients were prospectively enrolled in Seoul National University Hospital and 99 among them were completely followed up according to our protocol. After H. pylori eradication, tumoural response was evaluated by endoscopy and histopathology every 2 -3 months till complete remission (CR) and every 6 months after achieving CR. Median follow-up period was 41 months (range, 11 -125 months). Helicobacter pylori was successfully eradicated in all 99 patients and CR was obtained in 84 (84.8%) of 99 patients. The median time to reach CR was 3 months and 94% of CR is in continuous complete remission. Five patients with CR relapsed after 10 -22 months without the evidence of H. pylori reinfection. Cumulative recurrence rate was 2.3, 7.7 and 9.3% at 1, 2 and 3 years, respectively. Tumours were mainly located in distal stomach (67.7%) and tumours in distal stomach were associated with more favourable response than those in proximal stomach (P ¼ 0.001). Majority of patients with low-grade gastric MALT lymphoma treated by exclusive H. pylori eradication have a favourable long-term outcome, offering a real chance of cure. Tumour location could be a predictive factor for remission following H. pylori eradication.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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Helicobacter pylori eradication for low-grade gastric mucosa-associated lymphoid tissue lymphoma is more successful in inducing remission in distal compared to proximal disease

et al. 2007

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“…In addition, a series of in vitro studies showed that lymphoma growth could be stimulated in culture by H pylori strain-specific T cells when crude lymphoma cultures were exposed to the organism [12] . Finally, Wotherspoon et al [13] in 1993, and subsequently several other groups [14][15][16][17][18][19][20][21][22][23][24][25] , showed that eradication of H pylori with antibiotics alone resulted in regression of gastric MALT lymphoma in 60%-90% of cases.…”

Section: Role Of H Pylori In Lymphomagenesismentioning

confidence: 97%

“…[14][15][16][17][18][19][20][21][22][23][24][25]60] ; but until recently only few data existed on the long-term stability of the remissions induced. A recent paper by Wündisch and co-workers [24] report on the longterm follow up of 120 patients with stageⅠdisease.…”

Section: What Stage-what Kind Of Therapy?mentioning

confidence: 99%

Therapy of gastric mucosa associated lymphoid tissue lymphoma

Morgner

Schmelz²,

Thiede³

et al. 2007

WJG

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Gastric mucosa associated lymphoid tissue (MALT) lymphoma has recently been incorporated into the World Health Organization (WHO) lymphoma classification, termed as extranodal marginal zone B-cell lymphoma of MALT-type. In about 90% of cases this lymphoma is associated with H pylori infection which has been clearly shown to play a causative role in lymphomagenesis. Although much knowledge has been gained in defining the clinical features, natural history, pathology, and molecular genetics of the disease in the last decade, the optimal treatment approach for gastric MALT lymphomas, especially locally advanced cases, is still evolving. In this review we focus on data for the therapeutic, stage dependent management of gastric MALT lymphoma. Hence, the role of eradication therapy, surgery, chemotherapy and radiotherapy is critically analyzed. Based on these data, we suggest a therapeutic algorithm that might help to better stratify patients for optimal treatment success.

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Radiation therapy for localized low-grade non-Hodgkin's lymphomas

Tsang

Gospodarowicz

2005

Hematol. Oncol.

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The most common low grade B-cell non-Hodgkin's lymphomas are follicular lymphomas, and extranodal marginal zone lymphomas, also known as mucosa-associated lymphoid tissue (MALT) lymphomas. Localized presentations of follicular lymphoma occur in 20-30% of cases, while for MALT lymphomas, stage I-II disease presentations occur in 70-90%. These are radiation-sensitive lymphomas. Following moderate dose local radiation treatment (30-35 Gy) for these stage I and II low grade lymphomas, the clinical results indicate long-term local control and possible cure. While local control is achieved with minimal morbidity with involved-field radiation therapy, a significant proportion of patients relapse with systemic disease outside of radiation fields. For follicular lymphoma, this occurs in approximately 50% of patients after 15 years, and for non-gastric MALT lymphoma, 30-40% after 10 years. Although patients with relapsed systemic disease are not curable with chemotherapy, the disease often behaves in an indolent fashion and prolonged survival is observed. For gastric MALT lymphomas, radiation therapy is indicated in patients whose lymphoma did not respond to Helicobacter pylori eradication therapy, or in gastric lymphoma not related to this microorganism. The subject of causative agents responsible for non-gastric MALT lymphomas is under active study and the identification of putative microorganisms will lead to improved treatment strategies for these unusual lymphomas, similar to the success in gastric lymphomas over the last decade.

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Relapse of Low-Grade Gastric MALT Lymphoma After Helicobacter Pylori Eradication: True Relapse or Persistence? Long-Term Post-Treatment Follow-Up of a Multicenter Trial in the North-East of Italy and Evaluation of the Diagnostic Protocol’s Adequacy

Cited by 55 publications

References 15 publications

Helicobacter pylori eradication for low-grade gastric mucosa-associated lymphoid tissue lymphoma is more successful in inducing remission in distal compared to proximal disease

Helicobacter pylori eradication for low-grade gastric mucosa-associated lymphoid tissue lymphoma is more successful in inducing remission in distal compared to proximal disease

Therapy of gastric mucosa associated lymphoid tissue lymphoma

Radiation therapy for localized low-grade non-Hodgkin's lymphomas

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