Prospective study of Helicobacter pylori eradication therapy in stage IE high-grade mucosa-associated lymphoid tissue lymphoma of the stomach

L. T. Chen, J. T. Lin, R. Y. Shyu, C. M. Jan, C. L. Chen, I. P. Chiang, S. M. Liu, I. J. Su, A. L. Cheng

Research output: Contribution to journalArticle

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Abstract

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 IE high-grade gastric MALT lymphomas. Patients and Methods: Sixteen patients with H pylori infection and stage IE 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 pylori dependence in early-stage MALT lymphomas of the stomach.

Original languageEnglish
Pages (from-to)4245-4251
Number of pages7
JournalJournal of Clinical Oncology
Volume19
Issue number22
Publication statusPublished - Nov 15 2001
Externally publishedYes

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Marginal Zone B-Cell Lymphoma
Helicobacter pylori
Non-Hodgkin's Lymphoma
Stomach
Prospective Studies
Pylorus
Therapeutics
Neoplasms
Lymphoma
Endosonography
Neoplasm Grading
Gastric Mucosa
Infection
Confidence Intervals
Anti-Bacterial Agents
Biopsy
Drug Therapy

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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Prospective study of Helicobacter pylori eradication therapy in stage IE high-grade mucosa-associated lymphoid tissue lymphoma of the stomach. / Chen, L. T.; Lin, J. T.; Shyu, R. Y.; Jan, C. M.; Chen, C. L.; Chiang, I. P.; Liu, S. M.; Su, I. J.; Cheng, A. L.

In: Journal of Clinical Oncology, Vol. 19, No. 22, 15.11.2001, p. 4245-4251.

Research output: Contribution to journalArticle

Chen, LT, Lin, JT, Shyu, RY, Jan, CM, Chen, CL, Chiang, IP, Liu, SM, Su, IJ & Cheng, AL 2001, 'Prospective study of Helicobacter pylori eradication therapy in stage IE high-grade mucosa-associated lymphoid tissue lymphoma of the stomach', Journal of Clinical Oncology, vol. 19, no. 22, pp. 4245-4251.
Chen, L. T. ; Lin, J. T. ; Shyu, R. Y. ; Jan, C. M. ; Chen, C. L. ; Chiang, I. P. ; Liu, S. M. ; Su, I. J. ; Cheng, A. L. / Prospective study of Helicobacter pylori eradication therapy in stage IE high-grade mucosa-associated lymphoid tissue lymphoma of the stomach. In: Journal of Clinical Oncology. 2001 ; Vol. 19, No. 22. pp. 4245-4251.
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abstract = "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 IE high-grade gastric MALT lymphomas. Patients and Methods: Sixteen patients with H pylori infection and stage IE 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 pylori dependence in early-stage MALT lymphomas of the stomach.",
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T1 - Prospective study of Helicobacter pylori eradication therapy in stage IE high-grade mucosa-associated lymphoid tissue lymphoma of the stomach

AU - Chen, L. T.

AU - Lin, J. T.

AU - Shyu, R. Y.

AU - Jan, C. M.

AU - Chen, C. L.

AU - Chiang, I. P.

AU - Liu, S. M.

AU - Su, I. J.

AU - Cheng, A. L.

PY - 2001/11/15

Y1 - 2001/11/15

N2 - 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 IE high-grade gastric MALT lymphomas. Patients and Methods: Sixteen patients with H pylori infection and stage IE 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 pylori dependence in early-stage MALT lymphomas of the stomach.

AB - 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 IE high-grade gastric MALT lymphomas. Patients and Methods: Sixteen patients with H pylori infection and stage IE 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 pylori dependence in early-stage MALT lymphomas of the stomach.

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