Gastric malt lymphoma: Analysis of a series of consecutive patients over 20 years

Abstract

Introduction and aims: Gastric mucosa-associated lymphoid tissue (MALT) lymphoma is closely associated with Helicobacter pylori (HP) infection. Our aim was to evaluate demographic, clinical and endoscopic characteristics of gastric MALT lymphoma patients, as well as to analyse response to treatment and factors that affect complete remission (CR) and relapse. We also assessed the long-term prognosis. Methods: The study involved a retrospective evaluation of consecutive patients admitted with gastric MALT lymphoma . Results: A total of 144 patients (76 men; mean age 56) were included. At stage EI, 94/103 patients (92%) received HP eradication and 78 (83%) achieved CR after a mean period of 7 months (2-63 months) and 67 (86%) remained in CR after a mean follow-up time of 105 months. HP infection status (p ¼ 0.004) and lymphoma localisation to the antrum plus body (p ¼ 0.016) were associated with higher and lower CR rates, respectively. Relapse occurred in 11/78 (14%) patients after a mean period of 21 months. The absence of HP re-infection (p ¼ 0.038), the need of only one eradication regimen (p ¼ 0.009) and antrum lymphomas (p ¼ 0.031) correlated with lower relapse rates. At stage EII, HP eradication was performed in 17/24 patients but only five experienced CR (30%). Among 16 patients diagnosed at stage EIV, nine achieved CR after chemotherapy AE surgery and 3/7 without remission died due to disease progression. The 5-and 10-year overall disease free survival rates were 90.5% and 79.1%, respectively. Conclusions: Most patients were diagnosed at an early stage. Eradication therapy was highly effective in inducing complete remission. Long-term evaluation showed that the long-term prognosis was very favourable.

Helicobacter pylori, gastric cancer and other gastrointestinal malignancies

“…Among 16 patients diagnosed at stage EIV, nine achieved CR after chemotherapy ± surgery and 3 of 7 without remission died due to disease progression. The 5‐ and 10‐year overall disease free survival rates were 90.5% and 79.1%, respectively …”

“…The 5and 10-year overall disease free survival rates were 90.5% and 79.1%, respectively. 8 In another retrospective study, the effectiveness of H. pylori eradication therapy was assessed in 345 Korean patients with GML, regardless of the H. pylori infection status or disease stage. H. pylori infection was detected in 317 of 345 patients (91.9%).…”

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

“…15 and 83% (78/94) in a Portuguese single-center retrospective study. 22 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).…”

Bacteriological Investigation of Helicobacter pylori Infections in Patients with Gastric and Duodenal Ulcer

“…H. pylori are also implicated in the majority of cases of peptic ulcer disease, particularly duodenal ulcer. Eradication therapy is both effective in healing peptic ulcer disease and in preventing relapse, and is cost-effective (Moleiro et al, 2016).H. pylori infection has also been associated with weight loss and failure to thrive among older adults.…”