This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Save to my personal folders Download to citation manager Rights & Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Chen, L.-T. Articles by Cheng, A.-L. Search for Related Content PubMed PubMed Citation Articles by Chen, L.-T. Articles by Cheng, A.-L. Social Bookmarking                            What's this?

Prospective Study of Helicobacter pylori Eradication Therapy in Stage I_E High-Grade Mucosa-Associated Lymphoid Tissue Lymphoma of the Stomach

From the Division of Cancer Research, National Health Research Institutes; Departments of Internal Medicine, Oncology, and Pathology, National Taiwan University Hospital; Department of Internal Medicine, Tri-Service General Hospital; and Department of Pathology, Veteran General Hospital, Taipei; and Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.

Address reprint request to Ann-Lii Cheng, MD, PhD, Department of Internal Medicine, National Taiwan University Hospital, No 7, Chung-Shan S Rd, Taipei 100, Taiwan; email: andrew{at}ha.mc.ntu.edu.tw

PURPOSE: High-grade mucosa-associated lymphoid tissue (MALT) lymphomas of the stomach are generally believed to be Helicobacter pylori–independent, autonomously growing tumors. However, anecdotal cases of regression of high-grade lymphomas after the cure of H pylori infection had been described. The present prospective study was conducted to evaluate the effect of anti–H pylori therapy in stage I_E high-grade gastric MALT lymphomas.

PATIENTS AND METHODS: Sixteen patients with H pylori infection and stage I_E gastric high-grade MALT lymphoma consented to a brief antibiotic therapy as first-line treatment from June 1995 through April 2000. Then, patients underwent intensive endoscopic follow-up examinations (± endoscopic ultrasonography) with biopsy to evaluate tumor response. Patients with significant improvement of gross lesions that accompanied regression of large cells were followed up without additional treatment. Patients without significant improvement were immediately referred to systemic chemotherapy.

RESULTS: Eradication of H pylori was achieved in 15 patients and was accompanied by rapid gross tumor regression and disappearance of large cells in 10. All 10 of these patients with early response had subsequent complete histologic remission of lymphoma. The complete remission rate was 62.5% (95% confidence interval, 35.8% to 89.1%). The response rate was not affected by the tumor grading (proportion of large blast cells within the tumor) but was adversely affected by the depth of tumor invasion. At a median follow-up of 43.5 months (range, 21.1 to 67.4 months), all 10 of these patients remained lymphoma-free. The median duration of complete response was 31.2 months (range, 14.4 to 49.1 months).

CONCLUSION: These results suggest that high-grade transformation is not necessarily associated with the loss of H pyloridependence in early-stage MALT lymphomas of the stomach.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Facebook    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				A. Psyrri, S. Papageorgiou, and T. Economopoulos Primary extranodal lymphomas of stomach: clinical presentation, diagnostic pitfalls and management Ann. Onc., December 1, 2008; 19(12): 1992 - 1999. [Abstract] [Full Text] [PDF]

				H. Medina-Franco, S. S. Germes, and C. L. Maldonado Prognostic Factors in Primary Gastric Lymphoma Ann. Surg. Oncol., August 1, 2007; 14(8): 2239 - 2245. [Abstract] [Full Text] [PDF]

				C.-Y. Wu, M.-S. Wu, E.-P. Chiang, C.-C. Wu, Y.-J. Chen, C.-J. Chen, N.-H. Chi, G.-H. Chen, and J.-T. Lin Elevated plasma osteopontin associated with gastric cancer development, invasion and survival Gut, June 1, 2007; 56(6): 782 - 789. [Abstract] [Full Text] [PDF]

				W. Cheuk, J. K. C. Chan, G. Nuovo, M. K. M. Chan, and M. Fok Regression of Gastric Large B-Cell Lymphoma Accompanied by a Florid Lymphoma-like T-Cell Reaction: Immunomodulatory Effect of Ganoderma lucidum (Lingzhi)? International Journal of Surgical Pathology, April 1, 2007; 15(2): 180 - 186. [Abstract] [PDF]

				C.-Y. Wu, M.-S. Wu, E.-P. Chiang, Y.-J. Chen, C.-J. Chen, N.-H. Chi, Y.-T. Shih, G.-H. Chen, and J.-T. Lin Plasma Matrix Metalloproteinase-9 Level Is Better than Serum Matrix Metalloproteinase-9 Level to Predict Gastric Cancer Evolution Clin. Cancer Res., April 1, 2007; 13(7): 2054 - 2060. [Abstract] [Full Text] [PDF]

				S. M. Cohen, M. Petryk, M. Varma, P. S. Kozuch, E. D. Ames, and M. L. Grossbard Non-Hodgkin's Lymphoma of Mucosa-Associated Lymphoid Tissue Oncologist, November 1, 2006; 11(10): 1100 - 1117. [Abstract] [Full Text] [PDF]

				T.-Y. Cheng, J.-T. Lin, L.-T. Chen, C.-T. Shun, H.-P. Wang, M.-T. Lin, T.-E. Wang, A.-L. Cheng, and M.-S. Wu Association of T-Cell Regulatory Gene Polymorphisms With Susceptibility to Gastric Mucosa-Associated Lymphoid Tissue Lymphoma J. Clin. Oncol., July 20, 2006; 24(21): 3483 - 3489. [Abstract] [Full Text] [PDF]

				S. Wohrer, M. Troch, and M. Raderer Treatment of Localized Primary Gastric Lymphoma J. Clin. Oncol., June 10, 2006; 24(17): 2682 - 2682. [Full Text] [PDF]

				L.-T. Chen, J.-T. Lin, J. J. Tai, G.-H. Chen, H.-Z. Yeh, S.-S. Yang, H.-P. Wang, S.-H. Kuo, B.-S. Sheu, C.-M. Jan, et al. Long-Term Results of Anti-Helicobacter pylori Therapy in Early-Stage Gastric High-Grade Transformed MALT Lymphoma J Natl Cancer Inst, September 21, 2005; 97(18): 1345 - 1353. [Abstract] [Full Text] [PDF]

				K.-H. Yeh, S.-H. Kuo, L.-T. Chen, T.-L. Mao, S.-L. Doong, M.-S. Wu, H.-C. Hsu, Y.-S. Tzeng, C.-L. Chen, J.-T. Lin, et al. Nuclear expression of BCL10 or nuclear factor kappa B helps predict Helicobacter pylori-independent status of low-grade gastric mucosa-associated lymphoid tissue lymphomas with or without t(11;18)(q21;q21) Blood, August 1, 2005; 106(3): 1037 - 1041. [Abstract] [Full Text] [PDF]

				S.-H. Kuo, L.-T. Chen, K.-H. Yeh, M.-S. Wu, H.-C. Hsu, P.-Y. Yeh, T.-L. Mao, C.-L. Chen, S.-L. Doong, J.-T. Lin, et al. Nuclear Expression of BCL10 or Nuclear Factor Kappa B Predicts Helicobacter pylori-Independent Status of Early-Stage, High-Grade Gastric Mucosa-Associated Lymphoid Tissue Lymphomas J. Clin. Oncol., September 1, 2004; 22(17): 3491 - 3497. [Abstract] [Full Text] [PDF]

				S. Wohlfart, D. Sebinger, P. Gruber, J. Buch, D. Polgar, G. Krupitza, M. Rosner, M. Hengstschlager, M. Raderer, A. Chott, et al. FAS (CD95) Mutations Are Rare in Gastric MALT Lymphoma but Occur More Frequently in Primary Gastric Diffuse Large B-Cell Lymphoma Am. J. Pathol., March 1, 2004; 164(3): 1081 - 1089. [Abstract] [Full Text] [PDF]

				M M Alsolaiman, G Bakis, T Nazeer, R P MacDermott, and J A Balint Five years of complete remission of gastric diffuse large B cell lymphoma after eradication of Helicobacter pylori infection Gut, April 1, 2003; 52(4): 507 - 509. [Abstract] [Full Text] [PDF]

				S Ely, S Nakamura, M Iida, and T Matsumoto Distinction between "high grade MALT" and diffuse large B cell lymphoma Gut, December 1, 2002; 51(6): 893 - 894. [Full Text] [PDF]