Long-Term Outcomes of Gastric Mucosa-Associated Lymphoid Tissue Lymphomas after Helicobacter pylori Eradication Therapy

Abstract

Mucosa-associated lymphoid tissue (MALT) lymphomas are localized primarily in the gastrointestinal tract and are characterized by an indolent nature and favorable outcome with specifi c therapy. Gastric MALT lymphomas are closely linked to Helicobacter pylori (H. pylori) infection, for which eradication therapy is recognized as an effective primary treatment for the disease. However, there is little information about long-term outcomes after the therapy. In the present study, we elucidated the long-term outcomes of 74 patients (70 H. pylori-positive and 4 negative cases) followed up by endoscopy at least 12 months after exclusive eradication therapy alone. The median follow-up period was 46 months. When the remission status was estimated at the time point of 12 months post-eradication, the numbers of patients with complete remission (CR), histologically residual disease with macroscopic normalization (hRD), partial remission with more than 50% tumor reduction (PR) or no response (NR) were 56, 12, 2 and 4, respectively. During follow-ups of over 12 months post-eradication, 11 of the 12 hRD cases were belatedly induced to CR but one CR case histologically relapsed into hRD. One of the 2 PR cases eventually turned into hRD 20 months later. Therefore, 66 CR, 3 hRD, 1 PR, and 4 NR cases (including 3 H. pylorinegative) were identifi ed at the last follow-up of the present study. All 74 patients were followed up without any second-line therapies, but none exhibited disease progression. Thus, the long-term outcome of localized gastric MALT lymphoma after H. pylori eradication therapy was favorable. A watch and wait strategy may be a reasonable approach for hRD since the majority might be in the process of turning into delayed CR. gatric MALT lymphoma; H. pylori eradication; long-term outcome; complete remission; radiotherapy.Tohoku

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

“…The location, endoscopic appearance and clinical staging of the H. pylori-negative MALT lymphomas did not differ from the positive lymphomas in our previous study, whereas the positive rate of t(11;18)/API2-MALT1 in H. pylori-negative MALT lymphomas in the present study (63.6%) was substantially higher than that in H. pylori-positive cases in our previous study (11.5%) (Terai et al 2008).…”

“…Their clinical staging was determined by upper gastrointestinal (GI) tract endoscopy, colonoscopy, bone marrow puncture, X-ray computed tomography (CT) and/or positron emitting tomography (PET), applying the Lugano staging system (Zucca et al 1997). The chimeric transcript of t(11;18)(q21;q21) API2-MALT1 gene was investigated in 11 patients by either reverse-transcriptase polymerase chain reaction or fluorescence in situ hybridization as previously described (Terai et al 2008). All the patients were followed up with upper GI tract endoscopy every six months, and with X-ray CT or PET every year.…”

Helicobacter pylori-negative gastric mucosa-associated lymphoid tissue lymphomas: A review

“…The first-line treatment for H. pylori-negative gastric MALT lymphomas is also antibiotic therapy [36] . Even in the absence of H. pylori infection, several studies have reported that certain proportions of patients responded to this antibiotic therapy [3,4,14,30,[45][46][47][48][49][50][51][52] (Table 2). …”

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

“…Relapse of gastric MALT lymphoma was recorded in 64 of the 852 patients who achieved CR (7.5%), and treatment failure (relapse, PD, and/or non‐CR at ≥6 months after successful H. pylori eradication) was observed in 144 of all 1055 patients (13.6%). Table 3 summarizes 8 prospective studies,17, 18, 19, 30, 31, 32, 33 including the present investigation, of 47‐120 patients. The present study (n = 97) represents the third largest among these prospective studies.…”