Long-term outcome following Helicobacter pylori eradication in a retrospective study of 105 patients with localized gastric marginal zone B-cell lymphoma of MALT type

Stathis, Anastasios; Chini, Claudio; Bertoni, Francesco; Proserpio, Ilaria; Capella, Carlo; Mazzucchelli, Luca; Pedrinis, E; Cavalli, Franco; Pinotti, Graziella; Zucca, Emanuele

doi:10.1093/annonc/mdn760

Cited by 136 publications

(108 citation statements)

References 39 publications

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“…In recent years, several large‐scale studies have investigated the efficacy of H. pylori eradication therapy against gastric MALT lymphoma. Among previous studies with around 100 subjects, CR was achieved in 80% (96/120) in a German multicenter prospective study,17 94% (85/90) in a Korean prospective study,18 85% (84/99) in a Korean single‐center prospective study,19 74% (146/196) in a German single‐center retrospective study,20 76% (78/102) in a joint Swiss‐Italian retrospective study,21 77% (323/420) in a Japanese retrospective study,15 and 83% (78/94) in a Portuguese single‐center retrospective study 22. However, CR criteria varied among those studies.…”

Section: Discussionmentioning

confidence: 85%

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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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Section: Discussionmentioning

confidence: 85%

“…Table 2 indicates 9 retrospective studies 12, 15, 20, 21, 22, 26, 27, 28, 29 of 49‐376 patients. In total, CR was achieved in 852 of 1,055 patients (80.8%) including patients with successful and unsuccessful H. pylori eradication.…”

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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“…The clinical symptoms of gastric MALT lymphoma are non-specific and include epigastric pain, abdominal discomfort and bleeding. Lymphoma is often localized in the antrum, body and multifocal sites of the stomach and the common endoscopic types are ulcer, erosion and mucosa edema (27). A large number of biopsies should be taken from visible lesions and normal mucosa.…”

Section: Discussionmentioning

confidence: 99%

Clinical manifestations and epigenetic mechanisms of gastric mucosa associated lymphoid tissue lymphoma and long‑term follow‑up following Helicobacterï¿½pylori eradication

Song

Jiang

et al. 2017

Exp Ther Med

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Abstract. The current study aimed to summarize the clinical manifestations and identify the epigenetic mechanisms of gastric mucosa associated lymphoid tissue (MALT) lymphoma, as well as evaluate the long-term effects of Helicobacter pylori (H. pylori) eradication. A total of 122 patients with marginal zone B-cell lymphoma of primary gastric MALT lymphoma were enrolled in the present study. The clinical manifestations of gastric MALT lymphoma, including symptoms, H. pylori state and endoscopic type, were summarized. The response to therapy was evaluated in patients that underwent H. pylori eradication. Survival analysis was estimated using the Kaplan-Meier method. The expression of microRNA-383 (miR-383) in tumor tissues and cell lines was determined using reverse transcription quantitative polymerase chain reaction. Furthermore, bioinformatic analyses, luciferase reporter assays. and western blot analysis identified zinc finger E-box binding homeobox 2 (ZEB2) as a direct target gene of miR-383. An MTT assay was used to examine the function of miR-383 and ZEB2 in MALT lymphoma. The clinical symptoms of patients with gastric MALT lymphoma were non-specific and included epigastric pain, abdominal discomfort and bleeding. The majority of endoscopic types were classified as ulcer, erosion and mucosa edema. The H. pylori infection rate was 79.5% (97/122) and a total of 47 patients underwent eradication therapy. Lymphoma remission was achieved in 93.6% (44/47) of patients and complete remission (CR) was achieved in 74.4% (35/47). The median follow-up time was 38 months (range, 10-132 months) and the median time taken to achieve CR was 4 months (range, 3-7 months). The estimated 3-year survival rate was 90.3% and the 5-year survival rate was 76.2%. Therefore, it was determined that patients with stage I or II gastric MALT lymphoma are able to undergo H. pylori eradication as a first-line treatment and that the survival rate of patients undergoing this treatment is high. Furthermore, it was determined that the mechanism by which miR-383 and ZEB2 contribute to MALT lymphoma progression is by the targeting of ZEB2 by miR-383, which inhibits the proliferation of cancer cells.

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“…MALT lymphoma of the stomach If coincident infection with Helicobacter pylori is present and the lymphoma is localized to the stomach and peri-gastric lymph nodes, treatment with antibiotics and H2 blockers can eliminate the organism-related antigenic stimulus and the lymphoma may regress permanently. 8,9 This is quite unlikely to happen if t(11;18) is present, which testing should be included in processing of gastric MALT lymphomas. 10 2.…”

Section: What Does the Clinician Do: Treatment Choicementioning

confidence: 99%

Non-Hodgkin lymphoma: the clinician's perspective—a view from the receiving end

Connors

2013

Modern Pathology

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Optimal treatment of non-Hodgkin lymphoma depends on establishing an accurate diagnosis and determining the stage or anatomic extent of the lymphoma. With this information, the treating clinician can assign the lymphoma to a subgroup characterized by expected natural history: indolent, aggressive, acute leukemia-like or viral, which generally reflects the typical behavior of the disease unmodified by treatment and indicates the urgency with which intervention must be offered. Finally, a number of special circumstances and problems posed by specific lymphomas must be anticipated and the therapeutic plan altered to accommodate them. After primary treatment, special secondary events such as transformation to more aggressive histologic types must be recognized and the treatment plan must be altered to address these events. This article reviews standard diagnostic grouping of lymphomas, special problems encountered during primary diagnosis and subsequent clinical evolution and emphasizes the cooperative interaction between the hematopathologist and the treating clinician that underlies optimal management.

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Long-term outcome following Helicobacter pylori eradication in a retrospective study of 105 patients with localized gastric marginal zone B-cell lymphoma of MALT type

Abstract: Helicobacter pylori eradication resulted in complete lymphoma remission in the majority of cases. Long-term clinical disease control was achieved in most patients. A watch and wait policy appears to be safe in patients with minimal residual disease or histological-only local relapse.

Cited by 136 publications

References 39 publications

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

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

Clinical manifestations and epigenetic mechanisms of gastric mucosa associated lymphoid tissue lymphoma and long‑term follow‑up following Helicobacterï¿½pylori eradication

Non-Hodgkin lymphoma: the clinician's perspective—a view from the receiving end

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