Treatment Outcome for Gastric Mucosa-Associated Lymphoid Tissue Lymphoma according toHelicobacter pyloriInfection Status: A Single-Center Experience

Abstract

Background/AimsHelicobacter pylori eradication therapy has been used as a first-line treatment for H. pylori-positive gastric mucosa-associated lymphoid tissue (MALT) lymphoma. However, the management strategy for H. pylori-negative MALT lymphoma remains controversial. Therefore, the aim of this study was to examine the success rate of each treatment option for H. pylori-positive and H. pylori-negative gastric MALT lymphomas.MethodsIn total, 57 patients with gastric MALT lymphoma diagnosed between December 2000 and June 2012 were enrolled in the study. The treatment responses were compared between H. pylori-positive and H. pylori-negative gastric MALT lymphomas.ResultsOf the 57 patients, 43 (75%) had H. pylori infection. Forty-eight patients received H. pylori eradication as a first-line treatment, and complete remission was achieved in 31 of the 39 patients (80%) with H. pylori-positive MALT lymphoma and in five (56%) of the nine patients with H. pylori-negative MALT lymphoma; no significant difference was observed between the groups (p=0.135). The other treatment modalities, including radiation therapy, chemotherapy, and surgery, were effective irrespective of H. pylori infection status, with no significant difference in the treatment response between H. pylori-positive and H. pylori-negative MALT lymphomas.ConclusionsH. pylori eradication therapy may be considered as a first-line treatment regardless of H. pylori infection status.

Depth of Remission Following First-Line Treatment Is an Independent Prognostic Marker for Progression-Free Survival in Gastric Mucosa-Associated Lymphoid Tissue (MALT) Lymphoma

“…In fact, this is comparable to other larger series and is well within or exceeding the range of the median time to relapse/progression, which is between 4-5 years in the current literature [3,23]. In addition, a prolonged follow-up to correctly assess response is especially important in patients undergoing H. pylori eradication, where individual time to best response can be in excess of two years [3,[6][7][8][9][10][11][12]. This was also highlighted in a study by Fischbach et al in which 32% of patients in PR after 12 months consecutively converted to CR with prolonged follow-up (median follow-up of 42 months) [15].…”

“…Long-term outcome following first line antibiotic eradication for localized gastric MALT lymphoma is favorable with up to 80% durable remissions and 5-year survival rates of approximately 90% according to most reported series [8][9][10][11][12]. However, while the rate of complete remissions (CR) is reported to be in the range of 60-75%, approximately one third of patients show persistent disease in follow-up biopsies classified either as no change (NC), or with signs of lymphoma regression described as responding residual disease (rRD) or probable minimal residual disease (pMRD), according to GELA (Groupe d' Etude des Lymphomes de l' Adulte) histological response criteria, a grading system specifically developed for post-treatment biopsies of gastric MALT lymphoma [13,14].…”

Once in a Blue Moon, the Bone Marrow Aspiration and Biopsy Has Clinical Impact for Gastric Mucosa-Associated Lymphoid Tissue Lymphoma

“…Early gastric cancer overtakes the advance cancer, and it must be true for gastric MALT lymphoma. Literatures from Korea and Japan, gastric MALT lymphoma is mostly stage IE and bone marrow involvement is rare 8,9. This article also reported 0.5% of bone marrow involvement.…”

Front‐line management of indolent non‐Hodgkin lymphoma in Australia. Part 2: mantle cell lymphoma and marginal zone lymphoma

“…For patients with localised disease who are H. pylori negative, empiric eradication therapy may still be beneficial in a significant proportion of patients . Similarly, clarithromycin therapy has resulted in meaningful response rates in some patients with gastric MALT lymphoma (and other subtypes) …”