scholarly journals Long-Term Clinical Outcomes of Gastric MALT Lymphoma: A Nationwide Multicenter Study in Korea

2021 ◽  
Vol 11 ◽  
Author(s):  
Joon Sung Kim ◽  
Jun Chul Park ◽  
Jong Yeul Lee ◽  
Ji Yong Ahn ◽  
Sun Hyung Kang ◽  
...  
Keyword(s):  
Overall Survival ◽  
Malt Lymphoma ◽  
Case Series ◽  
Stage Iii ◽  
Gastric Malt Lymphoma ◽  
University Hospitals ◽  
Initial Stage ◽  
Testing Stage ◽  
H Pylori

BackgroundTreatment recommendations for gastric mucosa-associated lymphoid tissue (MALT) lymphoma are based on case series and expert opinions. Only a few previous studies have focused on the long-term outcomes of gastric MALT lymphoma, especially according to stage.MethodsPatients diagnosed with gastric MALT lymphoma from January 2000 to December 2018 at nine university hospitals in Korea were included. Clinical data of medical history, endoscopic features, histological diagnosis, results of Helicobacter pylori (H. pylori) testing, stage, treatment conditions, and outcomes were collected.ResultsA total of 1,163 patients was enrolled, and 97.6% (n=1,038) of patients were diagnosed as stage IE. 10-year overall survival (OS) for the entire population was 99.1% and was better for patients in stage IE compared with patients in stage III/IV (p=0.002). The 10-year OS for H. pylori-positive patients was better than that of H. pylori-negative patients (p=0.022). Multivariate analyses revealed initial stage III/IV as a prognostic factor associated with over-all survival.ConclusionThe majority of gastric MALT lymphoma patients are diagnosed at an early localized stage in Korea. The overall survival rate of gastric MALT lymphoma is excellent and is associated with the initial stage of the disease.

scholarly journals MALT lymphoma: epidemiology, clinical diagnosis and treatment

2018 ◽  
Vol 11 (3) ◽  
pp. 187-193 ◽  
Author(s):  
Petruta Violeta Filip ◽  
◽  
Denisa Cuciureanu ◽  
Laura Sorina Diaconu ◽  
Ana Maria Vladareanu ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
B Cell ◽  
Malt Lymphoma ◽  
Cell Lymphoma ◽  
Gastric Lymphoma ◽  
Eradication Therapy ◽  
B Cell Lymphoma ◽  
Gastric Malt Lymphoma ◽  
H Pylori

Primary gastric lymphoma (PGL) represents a rare pathology, which can be easily misdiagnosed because of unspecific symptoms of the digestive tract. Histologically, PGL can vary from indolent marginal zone B-cell lymphoma of the mucosa-associated lymphoid tissue (MALT) to aggressive diffuse large B-cell lymphoma (DLBCL). During the years, clinical trials revealed the important role of Helicobacter pylori (H. pylori) in the pathogenesis of gastric MALT lymphoma. Infection with Helicobacter pylori is an influential promoter of gastric lymphomagenesis initiation. Long-term studies revealed that eradication therapy could regress gastric lymphomas.

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.

Long-term follow-up of gastric malt lymphoma after H. pylori eradication

2001 ◽  
Vol 3 (6) ◽  
pp. 516-522 ◽  
Author(s):  
Andrea Morgner ◽  
Christian Thiede ◽  
Ekkehard Bayerdörffer ◽  
Birgit Alpen ◽  
Thomas Wündisch ◽  
...  
Keyword(s):  
Malt Lymphoma ◽  
Gastric Malt Lymphoma ◽  
Long Term Follow Up ◽  
H Pylori

Helicobacter pylori and mucosa-associated lymphoid tissue: what's new

Hematology ◽  
2013 ◽  
Vol 2013 (1) ◽  
pp. 109-117 ◽  
Author(s):  
Sung-Hsin Kuo ◽  
Ann-Lii Cheng
Keyword(s):  
Malt Lymphoma ◽  
Lymphoid Tissue ◽  
Early Stage ◽  
Eradication Therapy ◽  
Gastric Malt Lymphoma ◽  
High Grade ◽  
First Line ◽  
Histological Evidence ◽  
H Pylori

AbstractLow-grade mucosa-associated lymphoid tissue (MALT) lymphoma of the stomach, gastric MALT lymphoma, is associated with Helicobacter pylori infection. The eradication of H pylori using antibiotics is successful in 60% to 80% of affected patients. In contrast to the previous paradigm, we and other investigators have shown that a certain proportion of patients with H pylori–positive early-stage diffuse large B-cell lymphoma (DLBCL) of the stomach with histological evidence of MALT lymphoma, including high-grade transformed gastric MALT lymphoma and gastric DLBCL(MALT), achieved long-term complete pathological remission (pCR) after first-line H pylori eradication therapy, indicating that the loss of H pylori dependence and high-grade transformation are separate events in the progression of gastric lymphoma. In addition, patients with H pylori–positive gastric DLBCL without histological evidence of MALT (gastric pure DLBCL) may also respond to H pylori eradication therapy. A long-term follow-up study showed that patients who achieved pCR remained lymphoma free. Gastric MALT lymphoma is indirectly influenced by H pylori infection through T-cell stimulation, and recent studies have shown that H pylori–triggering chemokines and their receptors, H pylori–associated epigenetic changes, H pylori–regulated miRNA expression, and tumor infiltration by CD4+CD25+ regulatory T cells contribute to lymphomagenesis of gastric MALT lymphoma. Recent studies have also demonstrated that the translocation of CagA into B lymphocytes inhibits apoptosis through p53 accumulation, BAD phosphorylation, and the up-regulation of Bcl-2 and Bcl-XL expression. In gastric MALT lymphoma, CagA may stimulate lymphomagenesis directly, through the regulation of signal transduction, and intracellular CagA is associated with H pylori dependence. These findings represent a substantial paradigm shift compared with the classical theory of H pylori–reactive T cells contributing indirectly to the development of MALT lymphoma. In conclusion, a wide range of H pylori–related gastric lymphomas have been identified. The use of antibiotics as the sole first-line therapy for early-stage gastric pure DLBCL requires validation in a prospective study. The clinical and biological significance of the CagA oncoprotein in the lymphomagenesis of gastric MALT lymphoma warrants further study.

Management and long-term follow-up of early stage H. pylori-associated gastric MALT-lymphoma in clinical practice: An Italian, multicentre study

2009 ◽  
Vol 41 (7) ◽  
pp. 467-473 ◽  
Author(s):  
A. Andriani ◽  
A. Miedico ◽  
L. Tedeschi ◽  
C. Patti ◽  
F. Di Raimondo ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Multicentre Study ◽  
Malt Lymphoma ◽  
Early Stage ◽  
Gastric Malt Lymphoma ◽  
Long Term Follow Up ◽  
H Pylori

scholarly journals Involved-site radiotherapy for Helicobacter pylori–independent gastric MALT lymphoma: 26 years of experience with 178 patients

2021 ◽  
Vol 5 (7) ◽  
pp. 1830-1836
Author(s):  
Joachim Yahalom ◽  
Amy J. Xu ◽  
Ariela Noy ◽  
Stephanie Lobaugh ◽  
Monica Chelius ◽  
...  
Keyword(s):  
Overall Survival ◽  
Helicobacter Pylori ◽  
Malt Lymphoma ◽  
Treatment Options ◽  
Stage Iv ◽  
Standard Of Care ◽  
Cancer Center ◽  
Gastric Malt Lymphoma ◽  
H Pylori

Abstract Treatment options for Helicobacter pylori–independent gastric mucosa-associated lymphoid tissue (MALT) lymphoma (GML) include surgery, immunotherapy, chemotherapy, and radiation therapy (RT). The purpose of this study was to investigate the efficacy and safety of RT and routine endoscopic surveillance, hypothesizing that most patients are curable with RT alone. We queried a single institution database at a tertiary referral cancer center for patients with H pylori–independent GML treated with RT between 1991 and 2017. Response was assessed by follow-up endoscopies (EGDs) starting 10 to 12 weeks post-RT. Computed tomography scans were also part of the follow-up program, and positron emission tomography was added when clinically appropriate. We identified 178 patients (median age, 63 years; range, 25-89 years); 86% had stage I disease, 7% had stage II disease, and 7% had stage IV disease. Median RT dose was 3000 cGy over 20 fractions. Ninety-five percent of patients exhibited complete pathologic response on posttreatment EGD. Two patients experienced grade 3 toxicity, and 2 patients experienced in-field secondary malignancies. Over a median follow-up of 6.2 years, 9.6% experienced local failures, and 11.8% developed distant sites of disease. Five-year and 10-year overall survival were 94% and 79%, respectively, from last date of RT. RT is a highly effective and safe treatment for GML with excellent overall survival and very rare acute or late treatment-related toxicities. Favorable outcomes from this large retrospective sample of patients provide credible and compelling support for RT as standard of care for H pylori–independent GML.

Long-Term Persistence of Monoclonal B Cells After Cure of Helicobacter pylori Infection and Complete Histologic Remission in Gastric Mucosa–Associated Lymphoid Tissue B-Cell Lymphoma

2001 ◽  
Vol 19 (6) ◽  
pp. 1600-1609 ◽  
Author(s):  
Christian Thiede ◽  
Thomas Wündisch ◽  
Birgit Alpen ◽  
Beatrix Neubauer ◽  
Andrea Morgner ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
B Cells ◽  
Sequence Analysis ◽  
Gastric Mucosa ◽  
Malt Lymphoma ◽  
Lymphoid Tissue ◽  
Gastric Malt Lymphoma ◽  
Low Grade ◽  
H Pylori

PURPOSE: Cure of Helicobacter pylori infection is associated with remission induction in the majority of patients with low-grade gastric mucosa associated lymphoid tissue (MALT) lymphoma in localized stages; however, limited data exist as to whether these patients may be cured of their lymphoma. The present study was performed to investigate whether the polymerase chain reaction (PCR) for the rearranged immunoglobulin heavy chain region may be used to define “molecular” remission. PATIENTS AND METHODS: Ninety-seven patients who suffered from low-grade gastric MALT lymphoma stage IE were observed with central pathology and molecular biology after cure of H pylori infection. PCR was performed with the use of consensus primers for the framework regions 1, 2, and 3 and monoclonality was corroborated by sequence analysis. In selected cases, microdissection was performed to study the origin of the monoclonal B cells. RESULTS: Of the 97 patients, 77 obtained complete endoscopic and histologic remission (CR). Twenty of 44 patients with PCR monoclonality at diagnosis and with sufficient molecular follow-up displayed monoclonal bands for a median time of 20.5 months after CR (range, 0 to 50.4 months). These B cells were related to the original lymphoma clone by sequence analysis. Microdissection analysis identified basal lymphoid aggregates as the source of these monoclonal B cells. Local relapse occurred in and was observed by PCR in four patients. All four patients displayed monoclonal PCR before relapse, and three of these four showed ongoing PCR monoclonality throughout their course, indicating the persistence of malignant cells. CONCLUSION: Half of all patients with gastric MALT lymphoma show long-term PCR monoclonality up to several years after cure of H pylori infection and CR. Patients with monoclonal PCR should be observed closely, whereas long-term PCR negativity may indicate cure of the disease.

Long-term follow-up of gastric MALT lymphoma treated by eradication of H. pylori with antibiotics

1999 ◽  
Vol 117 (3) ◽  
pp. 750-751 ◽  
Author(s):  
Peter G. Isaacson ◽  
Timothy C. Diss ◽  
Andrew C. Wotherspoon ◽  
Renzo Barbazza ◽  
Michele de Boni ◽  
...  
Keyword(s):  
Malt Lymphoma ◽  
Gastric Malt Lymphoma ◽  
Long Term Follow Up ◽  
H Pylori

scholarly journals Genetic Characterization and Clinical Features of Helicobacter pylori Negative Gastric Mucosa-Associated Lymphoid Tissue Lymphoma

Cancers ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 2993
Author(s):  
Barbara Kiesewetter ◽  
Christiane Copie-Bergman ◽  
Michael Levy ◽  
Fangtian Wu ◽  
Jehan Dupuis ◽  
...  
Keyword(s):  
Gastric Mucosa ◽  
Signaling Pathways ◽  
Clinical Features ◽  
Malt Lymphoma ◽  
Lymphoid Tissue ◽  
Targeted Sequencing ◽  
Clinicopathological Parameters ◽  
Gastric Malt Lymphoma ◽  
Genetic Changes ◽  
H Pylori

Background: In Western countries, the prevalence of gastric mucosa-associated lymphoid tissue (MALT) lymphoma has declined over the last three decades. Contemporaneously, H. pylori negative gastric MALT lymphoma is increasingly encountered, and their genetic basis and clinical features remain elusive. Methods: A total of 57 cases of H. pylori negative gastric MALT lymphoma were reviewed and investigated for chromosome translocation by fluorescence in-situ hybridization and for somatic mutations by the targeted sequencing of 93 genes. Results: MALT1 translocation, most likely t(11;18)(q21;q21)/BIRC3-MALT1, was detected in 39% (22/57) cases, and IGH translocation was further seen in 12 MALT1-negative cases, together accounting for 60% of the cohort. Targeted sequencing was successful in 35 cases, and showed frequent mutations in NF-κB signaling pathways (TNFAIP3 = 23%, CARD11 = 9%, MAP3K14 = 9%), together affecting 14 cases (40%). The NF-κB pathway mutations were mutually exclusive from MALT1, albeit not IGH translocation, altogether occurring in 86% of cases. There was no significant correlation between the genetic changes and clinicopathological parameters. The patients showed a median of progression-free survival (PFS) of 66.3 months, and a significant superior PFS when treated with systemic versus antibiotic therapy (p = 0.004). Conclusion: H. pylori negative gastric MALT lymphoma is characterized by highly frequent genetic changes in the NF-κB signaling pathways.

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