Long Term Outcome of Gastric MALT Lymphoma Patients Treated with Anti-Helicobacter (Antibiotic and Proton-Pump Inhibitor) Regimens.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 2583-2583 ◽  
Author(s):  
Claudio Chini ◽  
Graziella Pinotti ◽  
Anastasios Stathis ◽  
Ilaria Proserpio ◽  
Francesco Bertoni ◽  
...  
Keyword(s):  
Malt Lymphoma ◽  
Proton Pump ◽  
Initial Treatment ◽  
Eradication Therapy ◽  
Gastric Malt Lymphoma ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Histological Score

Abstract Background: Primary mucosa-associated lymphoid tissue (MALT) lymphoma of the stomach is often associated with Helicobacter pylori (Hp) infection and Hp eradication therapy is widely accepted as initial treatment. The aim of this study is to report the clinical characteristics and long term outcome in a large series of patients with gastric MALT lymphoma exclusively treated with Hp eradication therapy. Methods: 105 newly diagnosed gastric MALT lymphoma patients (54 men and 51 women) with median age of 64 years (range 20–94) referred to our institutions between June 1990 and November 2006 were eligible for the study. Staging was performed according to the Lugano staging system. All patients received anti-Hp eradication therapy as initial treatment with standard regimens combining antibiotics (usually Amoxicillin, Clarithromycin and/or Metronidazole) and proton-pump inhibitors (Omeprazole in most cases). Responses, evaluated with regular endoscopic biopsies every 3–6 months were graded according to the Wotherspoon’s histological score system. Results: 100 patients had stage I and 5 patients had stage IIE1 disease. Hp was positive in 83 patients (79.5%) and was eradicated in all positive patients but 19 patients required a second line antibiotic therapy. Symptoms disappeared or markedly diminished and endoscopic features improved in almost all patients after Hp eradication. Histological regression of the gastric lymphoma was achieved in 78 of 102 evaluable patients (76%, 95% C.I.; 67%–84%) with histological complete response (Wotherspoon’s score 0–2) in 66 and partial response (score 3) in 12 patients. Of the 78 patients who achieved a lymphoma regression, the histological remission was consistently confirmed at follow-up endoscopies in 28 patients (36%), while 33 (42%) had histological score fluctuations (from 0–4), sometimes with transient histological relapses followed by spontaneous histological remissions. Ten patients had a frank lymphoma relapse (2 with high-grade transformation) and 7 died in remission for other causes. At a median follow up time of 6.3 years, the overall survival in the entire group is 92% at 5 years (95% C.I.; 84%–96%), 83% at 10 years (95% C.I.; 70%–91%) and 78% at 15 years (95% C.I.; 62%–88%). Only one patient died for lymphoma (after histological transformation). Additional tumors were observed in 22%. A history of autoimmune disease was present in 15% of the patients and did not affect the outcome. Conclusions: Hp eradication usually results in long term disease control, independently of the lymphoma pathological remission status. A watch and wait policy seems safe in patients with local histological relapse with no endoscopic evidence of gross disease.

scholarly journals Clinical Outcome of Eradication Therapy for Gastric Mucosa-Associated Lymphoid Tissue Lymphoma according toH. pyloriInfection Status

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Ju Seok Kim ◽  
Sun Hyung Kang ◽  
Hee Seok Moon ◽  
Jae Kyu Sung ◽  
Hyun Yong Jeong
Keyword(s):  
Complete Remission ◽  
Malt Lymphoma ◽  
Eradication Therapy ◽  
Gastric Malt Lymphoma ◽  
Clinicopathologic Characteristics ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Multiple Lesions ◽  
H Pylori

Background. To evaluate the long-term outcome ofH. pylorieradication therapy for gastric MALT lymphoma according to the presence ofH. pyloriinfection.Methods. We retrospectively reviewed the medical records of patients between January 2001 and June 2014. The clinicopathologic characteristics and clinical outcomes were compared betweenH. pylori-positive andH. pylori-negative gastric MALT lymphoma groups.Results. Fifty-four patients were enrolled: 12H. pylori-negative and 42H. pylori-positive patients. The tumor was located more frequently in both the proximal and distal parts of the stomach (P=0.001), and the percentage of multiple lesions was significantly greater in theH. pylori-negative group (P=0.046). Forty-seven patients received initial eradication therapy, and 85% (35/41) ofH. pylori-positive patients and 50% (3/6) ofH. pylori-negative patients achieved complete remission after eradication therapy. The presence of multiple lesions was a predictive factor for unresponsiveness toH. pylorieradication (P=0.024). The efficacy of eradication therapy (P=0.133), complete remission (CR) maintenance period, and relapse after eradication therapy were not significantly different between the two groups.Conclusions.H. pylorieradication therapy could be an effective first-line treatment for localizedH. pylori-negative gastric MALT lymphoma, especially for single lesions.

Very long term outcome of patients with gastric marginal zone B cell lymphoma of mucosa associated tissue (MALT) following Helicobacter pylori (Hp) eradication therapy

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 7531-7531
Author(s):  
C. Chini ◽  
I. Proserpio ◽  
M. E. Giudici ◽  
G. Pinotti ◽  
B. Pozzi ◽  
...  
Keyword(s):  
Median Time ◽  
Malt Lymphoma ◽  
Eradication Therapy ◽  
B Cell Lymphoma ◽  
Gastric Malt Lymphoma ◽  
Low Grade ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Histological Remission

7531 Background: Hp infection plays a decisive role in the pathogenesis of low-grade gastric MALT lymphoma and eradication therapy has become a widely accepted initial treatment of stage I disease. The aim of this study was to evaluate the long term outcome of patients (pts) with localized gastric MALT lymphoma exclusively treated with Hp eradication therapy. Methods: a prospective series of 62 newly diagnosed IE gastric MALT lymphoma pts (29M/33F) with median age of 63 years (range 27–87), referred to our department from June 1991 to January 2004 were evaluable for the study. Diagnosis was histologically proved and Hp status was evaluated. Staging was performed according to the modified Ann Arbor system. All pts received the triple eradicating therapy (OMC: omeprazole 20 mg bid, metronidazole 400 mg bid and clarithromycin 500 mg bid or OAC: omeprazole 20 mg bid, amoxycillin 1,000 mg bid and clarithromycin 500 mg bid) for one week. Response, evaluated every 6 months with multiple biopsies, was graded according to the Wotherspoon’s histologic scoring system. Results: Hp was eradicated in all patients, but 8 pts required a second line antibiotic therapy; symptoms disappeared or markedly diminished and endoscopic features improved in all pts. Histological remission (score 0–2) was observed in 57 pts (91.9%) after a median time of 6 months (range 2–72); 5 pts (8.1%) who failed to respond were referred to other treatments. With a median follow-up time of 76 months (range 12–162) the histological remission persists in 27/57 pts (47,4%); 21/57 pts (36.8%) have a continuous histological score fluctuation (from 0 to 4); 8/57 (14%) pts had an histological relapse (score 5) after a median time of 12 months (range 6–48) without Hp reinfection and 6 of them had a second spontaneous histological remission. The OS at 76 months is 93%. Only one patient died for an high grade gastric MALT lymphoma transformation. Conclusion: the majority of pts with gastric MALT lymphoma have a favourable long term outcome, independently of the pathological remission; eradication therapy may offer a real chance of cure. Watch and wait policy in agreement pts who failed to respond could be considered an option outside of clinical trial. No significant financial relationships to disclose.

scholarly journals Long-term outcome of patients with steroid-refractory acute severe UC treated with ciclosporin or infliximab

Gut ◽  
2017 ◽  
Vol 67 (2) ◽  
pp. 237-243 ◽  
Author(s):  
D Laharie ◽  
A Bourreille ◽  
J Branche ◽  
M Allez ◽  
Y Bouhnik ◽  
...  
Keyword(s):  
Initial Treatment ◽  
Survival Rates ◽  
Similar Efficacy ◽  
Long Term Results ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Free Survival ◽  
Steroid Refractory

ObjectiveCiclosporin and infliximab have demonstrated short-term similar efficacy as second-line therapies in patients with acute severe UC (ASUC) refractory to intravenous steroids. The aim of this study was to assess long-term outcome of patients included in a randomised trial comparing ciclosporin and infliximab.DesignBetween 2007 and 2010, 115 patients with steroid-refractory ASUC were randomised in 29 European centres to receive ciclosporin or infliximab in association with azathioprine. Patients were followed until death or last news up to January 2015. Colectomy-free survival rates at 1 and 5 years and changes in therapy were estimated through Kaplan-Meier method and compared between initial treatment groups through log-rank test.ResultsAfter a median follow-up of 5.4 years, colectomy-free survival rates (95% CI) at 1 and 5 years were, respectively, 70.9% (59.2% to 82.6%) and 61.5% (48.7% to 74.2%) in patients who received ciclosporin and 69.1% (56.9% to 81.3%) and 65.1% (52.4% to 77.8%) in those who received infliximab (p=0.97). Cumulative incidence of first infliximab use at 1 and 5 years in patients initially treated with ciclosporin was, respectively, 45.7% (32.6% to 57.9%) and 57.1% (43.0% to 69.0%). Only four patients from the infliximab group were subsequently switched to ciclosporin. Three patients died during the follow-up, none directly related to UC or its treatment.ConclusionsIn this cohort of patients with steroid-refractory ASUC initially treated by ciclosporin or infliximab, long-term colectomy-free survival was independent from initial treatment. These long-term results further confirm a similar efficacy and good safety profiles of both drugs and do not favour one drug over the other.Trial registration numberEudraCT: 2006-005299-42; ClinicalTrials.gouv number: NCT00542152; post-results.

Mid- and long-term outcome of Salter’s, Pemberton’s and Dega’s osteotomy for treatment of developmental dysplasia of the hip: a systematic review and meta-analysis

2020 ◽  
pp. 112070002094286
Author(s):  
Sophie R Merckaert ◽  
Pierre-Yves Zambelli ◽  
Shannon N Edd ◽  
Starnoni Daniele ◽  
Jolles Brigitte
Keyword(s):  
Systematic Review ◽  
Initial Treatment ◽  
Meta Analysis ◽  
Developmental Dysplasia ◽  
Unfavourable Outcome ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Dysplasia Of The Hip

Introduction: Early diagnosis and early treatment have become the gold standard for management of developmental dysplasia of the hip. Surgery is required in case of failed initial treatment. Innominate pelvic osteotomy of Salter (SIO), Pemberton’s pericapsular osteotomy (PPO) and Dega’s acetabuloplasty (DA) are among the most used procedures. We performed a systematic review and meta-analysis of the past 57 years in order to assess the mid- and long-term outcome of these techniques. Methods: Studies met inclusion criteria if they: (1) reported at least 5 cases treated by 1 of the abovementioned surgical techniques; (2) included children aged between 1 and 8 years; (3) surgical indication was late detected DDH or a failed initial treatment; (4) presented a minimal follow-up of 24 months; (5) reported the radiological score of Severin and/or the clinical score of McKay. Clinical and radiological outcomes were dichotomised into favourable and unfavourable outcome and weighted summary rates were determined using meta-analysis models. Results: From a total of 7391 articles, 48 level of evidence grade IV articles were included in our review. A total of 2143 cases with a mean follow up of 112.4 months were included. Pooled Severin score indicated a statistically better outcome for PPO and DA compared to SIO ( p = 0.0003 and p = 0.002, respectively). By dichotomising the results in favourable and unfavourable outcome, PPO showed the best results ( p = 0.0002 vs. SIO, p = 0.01 vs. DA). Pooled McKay score showed a statistically better outcome for PPO and DA compared to SIO ( p < 0.0001 and p = 0.03, respectively) as well as better outcomes for PPO compared to DA ( p = 0.01). By dichotomising the results in favourable and unfavourable, PPO showed the best results. Conclusions: Even if our review demonstrates slightly better radiological and clinical results with the PPO, the currently available and limited data do not allow for clear recommendation towards one of these techniques.

Helicobacter pylori eradication in gastric MALT lymphoma: Results of 316 patients treated inside and outside of a clinical trial

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 7584-7584
Author(s):  
T. Wündisch ◽  
A. Günther ◽  
C. Mösch ◽  
M. Huynh ◽  
M. Stolte ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Residual Disease ◽  
Remission Rate ◽  
Early Stage ◽  
Prospective Trial ◽  
Gastric Malt Lymphoma ◽  
Term Outcome ◽  
Long Term Outcome

7584 Background: Cure of infection induces remissions in most patients with early stage Helicobacter pylori- (Hp-) positive gastric MALT (mucosa-associated lymphoid tissue) lymphoma (GML). We compared the long-term outcome of 120 patients treated within a multicenter trial to that of 196 routinely treated patients. Methods: 120 patients with stage I1E disease from a prospective trial (cohort 1) were compared to 196 patients with GML treated outside a trail by sole Hp-eradication (cohort 2). The latter were evaluated in retrospect and only a minority had a complete staging at diagnosis. Histology was the standard for remission evaluation in all patients and performed by the same pathologist (MS). B-cell-clonality and the t(11;18) were assessed in cohort 1-patients. Results: Median endoscopic follow-up was 79 months (range, 1–121) in cohort 1-patients and 27 months (range, 0–120) in cohort 2-patients. In 41% of the cohort 2-patients no or one control endoscopy was performed after a first CR. Most patients are in continuous complete histological remission in both cohorts. 3 cohort 1- and 5 cohort 2-patients relapsed. 16 cohort 1- and 13 cohort 2-patients exhibited histological residual disease (RD) during follow up after a first CR; a watch-and-wait strategy was applied, and most entered into a second CR. Conclusions: Hp-eradication results in long term CR in the majority of patients with GML in both cohorts. Duration of remission, rate of relapse, and RD were similar, regardless of incomplete staging and follow-up procedures and higher age in the cohort 2-patients. No significant financial relationships to disclose.

Klinische Langzeitergebnisse der perkutanen transluminalen Angioplastie bei Patienten mit peripherer arterieller Verschlusskrankheit

VASA ◽  
2002 ◽  
Vol 31 (1) ◽  
pp. 36-42 ◽  
Author(s):  
. Bucek ◽  
Hudak ◽  
Schnürer ◽  
Ahmadi ◽  
Wolfram ◽  
...  
Keyword(s):  
Success Rate ◽  
Clinical Stage ◽  
Ankle Brachial Index ◽  
Clinical Situation ◽  
Clinical Results ◽  
Transluminal Angioplasty ◽  
Term Outcome ◽  
Long Term Outcome

Background: We investigated the long-term clinical results of percutaneous transluminal angioplasty (PTA) in patients with peripheral arterial occlusive disease (PAOD) and the influence of different parameters on the primary success rate, the rate of complications and the long-term outcome. Patients and methods: We reviewed clinical and hemodynamic follow-up data of 166 consecutive patients treated with PTA in 1987 in our department. Results: PTA improved the clinical situation in 79.4% of patients with iliac lesions and in 88.3% of patients with femoro-popliteal lesions. The clinical stage and ankle brachial index (ABI) post-interventional could be improved significantly (each P < 0,001), the same results were observed at the end of follow-up (each P < 0,001). Major complications occurred in 11 patients (6.6%). The rate of primary clinical long-term success for suprainguinal lesions was 55% and 38% after 5 and 10 years (femoro-popliteal 44% and 33%), respectively, the corresponding data for secondary clinical long-term success were 63% and 56% (60% and 55%). Older age (P = 0,017) and lower ABI pre-interventional (P = 0,019) significantly deteriorated primary clinical long-term success for suprainguinal lesions, while no factor could be identified influencing the outcome of femoro-popliteal lesions significantly. Conclusion: Besides an acceptable success rate with a low rate of severe complications, our results demonstrate favourable long-term clinical results of PTA in patients with PAOD.

Psychopathology 8½ Years Post Parasuicide

Crisis ◽  
1999 ◽  
Vol 20 (3) ◽  
pp. 115-120 ◽  
Author(s):  
Stephen Curran ◽  
Michael Fitzgerald ◽  
Vincent T Greene
Keyword(s):  
Rating Scales ◽  
Psychiatric Morbidity ◽  
Parental Bonding ◽  
Social Maladjustment ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Face To Face ◽  
Long Term Follow Up

There are few long-term follow-up studies of parasuicides incorporating face-to-face interviews. To date no study has evaluated the prevalence of psychiatric morbidity at long-term follow-up of parasuicides using diagnostic rating scales, nor has any study examined parental bonding issues in this population. We attempted a prospective follow-up of 85 parasuicide cases an average of 8½ years later. Psychiatric morbidity, social functioning, and recollections of the parenting style of their parents were assessed using the Clinical Interview Schedule, the Social Maladjustment Scale, and the Parental Bonding Instrument, respectively. Thirty-nine persons in total were interviewed, 19 of whom were well and 20 of whom had psychiatric morbidity. Five had died during the follow-up period, 3 by suicide. Migration, refusals, and untraceability were common. Parasuicide was associated with parental overprotection during childhood. Long-term outcome is poor, especially among those who engaged in repeated parasuicides.

Muenke syndrome: long-term outcome of a syndrome-specific treatment protocol

2019 ◽  
Vol 24 (4) ◽  
pp. 415-422 ◽  
Author(s):  
Bianca K. den Ottelander ◽  
Robbin de Goederen ◽  
Marie-Lise C. van Veelen ◽  
Stephanie D. C. van de Beeten ◽  
Maarten H. Lequin ◽  
...  
Keyword(s):  
Treatment Protocol ◽  
First Year ◽  
Ventricular Size ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Skull Growth ◽  
Muenke Syndrome ◽  
First Year Of Life

OBJECTIVEThe authors evaluated the long-term outcome of their treatment protocol for Muenke syndrome, which includes a single craniofacial procedure.METHODSThis was a prospective observational cohort study of Muenke syndrome patients who underwent surgery for craniosynostosis within the first year of life. Symptoms and determinants of intracranial hypertension were evaluated by longitudinal monitoring of the presence of papilledema (fundoscopy), obstructive sleep apnea (OSA; with polysomnography), cerebellar tonsillar herniation (MRI studies), ventricular size (MRI and CT studies), and skull growth (occipital frontal head circumference [OFC]). Other evaluated factors included hearing, speech, and ophthalmological outcomes.RESULTSThe study included 38 patients; 36 patients underwent fronto-supraorbital advancement. The median age at last follow-up was 13.2 years (range 1.3–24.4 years). Three patients had papilledema, which was related to ophthalmological disorders in 2 patients. Three patients had mild OSA. Three patients had a Chiari I malformation, and tonsillar descent < 5 mm was present in 6 patients. Tonsillar position was unrelated to papilledema, ventricular size, or restricted skull growth. Ten patients had ventriculomegaly, and the OFC growth curve deflected in 3 patients. Twenty-two patients had hearing loss. Refraction anomalies were diagnosed in 14/15 patients measured at ≥ 8 years of age.CONCLUSIONSPatients with Muenke syndrome treated with a single fronto-supraorbital advancement in their first year of life rarely develop signs of intracranial hypertension, in accordance with the very low prevalence of its causative factors (OSA, hydrocephalus, and restricted skull growth). This illustrates that there is no need for a routine second craniofacial procedure. Patient follow-up should focus on visual assessment and speech and hearing outcomes.

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