scholarly journals GASTRIC MALT LYMPHOMA AND HELYCOBACTER PYLORI INFECTION

2008 ◽  
Vol 37 (2) ◽  
pp. 99-105
Author(s):  
Aida Arnautovic-Custovic ◽  
Elmir Cickusic ◽  
Muharem Zildzic ◽  
Midhat Smajic
Keyword(s):  
Antibiotic Therapy ◽  
Malt Lymphoma ◽  
Malignant Tumors ◽  
Gastric Malt Lymphoma ◽  
Low Grade ◽  
Gastric Tumors ◽  
Endoscopy Unit ◽  
Ann Arbor ◽  
H Pylori ◽  
Treat All

Introduction: Gastric MALT lymphoma accounts aproximately 7% of all gastric tumors. Women are mostly affected by this disease (mean age 60 years). The aim of this study was to determine the incidence of gastric MALT lymphoma in the Endoscopy Unit of the Department of Gastroenterology Of University Clinical Center Tuzla, the degree of histological malignancy and correlation with the Helycobacter pylori infection and then to evaluate the effectiveness of triple-antibiotic therapy (protonic pump inhibitors and antacides) in treatment of these cases. Patients and methods: All the patiens in the study were performed with gastroscopy and mucosal tissue biopsy in the Endoscopy Unit of the Department of Gastroenterology of UKC Tuzla. PHD and IHH analysis of the given material were performed in the Patology Department of UKC Tuzla. The blood analyses on H. Pylori were done in the Department of Microbiology of UKC Tuzla. Results: 112 patients with gastric tumors were involved in this study, 91 of whom suffered from malignant tumors, six of them had MALT lymphoma (five of them had confirmed H. pylori infection, four had histologically confirmed low-grade tumors and two was categorised as high grade malignancies). Histological lesions were classified according to the actual Ann Arbor classification. Patients with high malignancy risk underwent the operative procedures, and then were treated by polychemiotherapy (CHOP protocole, VI-VIII cikluses). All the patients with confirmed H. pylori infection were treated with antibiotics for 2-4 months, after which complete eradication was accomplished in all cases. Patients histologicaly diagnosed with low grade malignancy showed complete histological regression. In addition to that, after triple antibiotic therapy none of the patients presented with the disease transformation into another histological form. Discussion and Conclusion: The results of this study prooved high incidence in use of triple antibiotic therapy in treatment of patients who suffer from MALT lymphoma with confirmed H. pylori infection. Besides, it is very important to emphasise the fact that patients had no side-effects during polychemiotherapy which was used to treat all the patients regardless of their histological type and malignancy degree of MALT lymphoma.

scholarly journals Can we eradicate gastric MALT-lymphoma?

2013 ◽  
pp. 154-158
Author(s):  
Angelo Zullo ◽  
Cesare Hassan ◽  
Francesca Cristofari ◽  
Claudia Iegri ◽  
Nicoletta Villiva ◽  
...  
Keyword(s):  
Malt Lymphoma ◽  
Early Stage ◽  
Gastric Lymphoma ◽  
Survival Rates ◽  
Antibody Therapy ◽  
Gastric Malt Lymphoma ◽  
Low Grade ◽  
Success Rates ◽  
H Pylori

The incidence of primary gastric lymphoma in Italy is considerably higher than that observed in the rest of Europe. It is widely accepted that gastric B-cell, low-grade mucosalassociated lymphoid tissue (MALT) lymphoma is caused by specific host-bacterial interactions that occur during Helicobacter pylori infection. This review examines recent findings on the origins, diagnosis, treatment, and follow-up of gastric MALT lymphomas. Clinical and endoscopic findings at diagnosis vary widely. In a substantial number of cases, the patient presents only vague dyspeptic symptoms or poorly defined abdominal pain with no macroscopic lesions on the gastric mucosa. Review of data from 32 trials in which a total of 1,387 MALT-lymphoma patients of the stomach were treated solely with H. pylori eradication revealed high remission rates when the disease is treated early (stage I-II1). Neoplasia confined to the submucosa, antral localization of tumors, and negativity for the API2-MALT1 translocation were associated with a high probability of remission following H. pylori eradication. When the latter approach is not sufficient, radiotherapy, chemotherapy and, in selected cases, surgery are associated with high success rates; data on the efficacy of monoclonal antibody therapy (rituximab) are still limited. Five-year survival rates are higher than 90%. Patients whose tumors have been eliminated require close, long-term endoscopic follow-up since recurrence has been reported in some cases. Broader clinical follow-up is also advisable because the incidence of other solid tumors and of cardiovascular events is reportedly increased in these patients.

scholarly journals Antibiotic Therapy of H. Pylori Negative Gastric MALT Lymphoma

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 1735-1735
Author(s):  
Seung Tae Lee ◽  
Purnima Teegavarupu ◽  
Anusha Karri ◽  
Saswatha Anireddy ◽  
Fredrick B. Hagemeister ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Antibiotic Therapy ◽  
Malt Lymphoma ◽  
Cell Transformation ◽  
Early Stage ◽  
Large Cell ◽  
Cancer Center ◽  
Gastric Malt Lymphoma ◽  
First Line ◽  
H Pylori

Abstract Introduction The causal association between H. pylori and gastric MALT lymphoma has been well demonstrated and H. pylori eradication with antibiotics has emerged as the standard therapy for Stage I H. pylori positive (HPP) gastric MALT lymphoma. As per the NCCN Guidelines, radiation therapy is the preferred treatment option for early stage H. pylori negative (HPN) gastric MALT lymphoma and antibiotic therapy is not indicated. However, successful treatment of HPN early stage gastric MALT lymphoma with antibiotics was reported in small series of patients by Raderer et al, Gut, 2006 [(5/6 patients achieved complete remission (CR)] and Asano et al, Tohoku J Exp Med, 2012 (5/17 patients achieved CR). Here, we report the outcome of Stage I HPP and HPN gastric MALT lymphoma patients treated with antibiotics at MD Anderson Cancer Center, Houston, Texas, USA over a period of 20 years. Methods We reviewed medical records of all pathologically proven gastric MALT lymphoma patients (n=128) referred to MD Anderson Cancer Center at initial diagnosis between 1991 and 2011. Only patients with Stage IAE disease were considered for this analysis. Patients with large cell transformation were excluded. H. pylori status was determined by histopathology and serum antibody assay. Clinical staging was determined by upper GI endoscopy with biopsy, bone marrow biopsy, and CT scans of neck, chest, abdomen, and pelvis and/or PET-CT scan. Response was assessed by upper GI endoscopy every 3-6 months until complete resolution of lymphoma. Complete remission was defined as the absence of histopathologic evidence of lymphoma on endoscopic biopsies. Results Of the 128 patients reviewed, 81 patients had Stage IAE disease without histologic evidence of large cell transformation. The 81 Stage IAE patients were assigned to HPP (39/81, 48%) or HPN group (42/81, 52%) based on histopathologic evidence of H. pylori. The higher-than-expected proportion of HPN patients might be due to referral bias to a tertiary care cancer center. The results of H. pylori antibody serology are shown in Table 1. There was no significant difference in age, gender, and race between HPP and HPN groups. First-line antibiotic therapy was administered for all 39 (100%) HPP patients and 28/42 (67%) HPN patients. The CR rate after antibiotic therapy was significantly higher in HPP compared with HPN patients (22/39, 56% vs 7/28, 25%; p=0.019). The median time to achieve a CR was similar for the two groups (HPP: 7.8 mo, range 3-40 mo; HPN: 9.7 mo, range 3-35 mo; p=0.385). After a median follow-up of 110 mo for the HPP group and 91.5 mo for the HPN group, 3/22 (14%) and 2/7 (28%) responders relapsed, respectively (p=0.362). Patients who failed to achieve a CR with antibiotic therapy were mostly treated with radiation: 14/17 in the HPP group and 19/21 in the HPN group. All patients that received radiation achieved a CR. Of the patients in both groups who received upfront antibiotic therapy, there were no differences in time to progression (HPP, 90% vs HPN, 92% at 8 years; p=0.543) and overall survival (HPP, 93% vs HPN, 100% at 8 years; p=0.068). Conclusions Our results demonstrate that a substantial proportion of patients with Stage IAE HPN gastric MALT lymphoma achieve durable remission with antibiotic therapy alone. It is possible that such responses may be because of false-negative H. pylori test results or due to association of HPN gastric MALT lymphoma with other unidentified bacteria. We also observed that HPN gastric MALT lymphoma patients failing antibiotic therapy could be effectively salvaged with radiation therapy and their long-term outcome is not affected by delay from initial trial of antibiotic therapy. Thus, the results of this largest series-to-date of HPN patients treated with first-line antibiotic therapy, combined with results of smaller series reported previously, suggest that 1) antibiotic therapy should be considered as first-line therapy for Stage IAE HPN gastric MALT lymphoma patients, and 2) radiation therapy could be avoided in a subset of these patients. Table 1. H. pylori status in Stage IAE gastric MALT lymphoma as determined by histopathology and H. pylori antibody. H. pylori positive by histology (n=39) H. pylori negative by histology (n=28) CR (n=22) Non-CR(n=17) CR (n=7) Non-CR(n=21) H. pylori Ab Positive 4 4 0 3 H. pylori Ab Negative 8 2 1 7 Not available 10 11 6 11 Figure 1 Figure 1. Disclosures No relevant conflicts of interest to declare.

The t(11; 18)(q21; q21) translocation in H. pylori-negative low-grade gastric MALT lymphoma

2000 ◽  
Vol 95 (11) ◽  
pp. 3314-3315 ◽  
Author(s):  
Tsuneya Nakamura ◽  
Shigeo Nakamura ◽  
Masakatsu Yonezumi ◽  
Masao Seto ◽  
Takio Yokoi
Keyword(s):  
Malt Lymphoma ◽  
Gastric Malt Lymphoma ◽  
Low Grade ◽  
H Pylori

Low-grade gastric mucosa-associated lymphoid tissue lymphoma: Clinicopathological factors associated with Helicobacter pylori eradication and tumor regression.

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. 353-353
Author(s):  
Hyun Ik Shim ◽  
Dong Ho Lee ◽  
Jae Ho Cho ◽  
Cheol Min Shin ◽  
Hyuk Yoon ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Gastric Mucosa ◽  
Malt Lymphoma ◽  
Lymphoid Tissue ◽  
Tumor Regression ◽  
Neutrophil Infiltration ◽  
Tumor Location ◽  
Gastric Malt Lymphoma ◽  
Low Grade ◽  
H Pylori

353 Background: Eradication of Helicobacter pylori is widely accepted as the initial therapy for low-grade gastric mucosa-associated lymphoid tissue (MALT) lymphoma. The aim of this study was to assess the remission and relapse rates of low-grade gastric MALT lymphoma after H. pylori eradication and to identify the clinical factors affecting remission. Methods: We retrospectively analyzed 151 patients diagnosed with gastric MALT lymphoma from May 2003 to December 2018. Results: Of the 151 patients, 112 (74.2%) had an H. pylori infection. Total regression rates with eradication was 90.2% (101/112) in H. pylori-positive patients and 55% (11/20) in H. pylori-negative patients. Age, sex, tumor location, endoscopic findings, and the severity of mononuclear lymphocytes were not related to achieving successful initial H. pylori eradication and remission. However, patients with a smaller H. pylori burden ( p=0.030) and less neutrophil infiltration ( p=0.003) were more likely to achieve a successful initial H. pylori eradication. H. pylori ( p<0.001) and the burden ( p=0.020) were significantly related to remission of MALT lymphoma. Conclusions: The results show that H. pylori burden and neutrophil infiltration were inversely related to the success of the initial H. pylori eradication procedure and that the H. pylori burden was inversely related to the remission of MALT lymphoma.

scholarly journals HELICOBACTER PYLORI AND t(11;18)(q21;q21) TRANSLOCATION IN GASTRIC MALT LYMPHOMA

2014 ◽  
Vol 51 (2) ◽  
pp. 84-89 ◽  
Author(s):  
Karine Sampaio LIMA ◽  
Walton ALBUQUERQUE ◽  
Vitor Nunes ARANTES ◽  
Ana Paula DRUMMOND-LAGE ◽  
Luiz Gonzaga Vaz COELHO
Keyword(s):  
Helicobacter Pylori ◽  
Malt Lymphoma ◽  
Tumor Regression ◽  
Histopathological Examination ◽  
Gastric Malt Lymphoma ◽  
Consecutive Series ◽  
Low Grade ◽  
Genetic Translocation ◽  
Tumor Involvement ◽  
H Pylori

ContextGastric mucosa-associated lymphoid tissue (MALT) lymphoma is clearly associated with Helicobacter pylori gastritis and can be cured with anti- H pylori therapy alone. The presence of t(11;18)(q21;q21) translocation is thought to predict a lower response rate to anti- H pylori treatment.ObjectivesTo study the presence of t(11;18)(q21;q21) genetic translocation and its clinical impact in low-grade gastric MALT lymphoma Brazilian patients.MethodsA consecutive series of eight patients with gastric MALT lymphoma were submitted to gastroscopy, endoscopic ultrasound, histopathological examination, H pylori search and RT-PCR-based methodology. All patients received anti-H pylori treatment. Eradicated patients were followed-up every 3-6 months for 2 years.ResultsEight patients were studied. All patients had tumor involvement restricted to the mucosa or submucosa and seven patients had low-grade gastric MALT lymphoma. All infected patients achieved H pylori eradication. Histological tumor regression was observed in 5/7 (71%) of the low-grade gastric MALT lymphoma patients. The presence of t(11;18)(q21;q21) translocation was found in 4 (57%) of these patients; among them only two had histological tumor regression following H pylori eradication.ConclusionsRT-PCR is a feasible and efficient method to detect t(11;18)(q21;q21) translocation, being carried out in routine molecular biology laboratories. The early detection of such translocation can be very helpful for better targeting the therapy to be applied to gastric MALT lymphoma patients.

scholarly journals Treatment of low-grade gastric malt lymphoma using Helicobacter pylori eradication

2015 ◽  
Vol 72 (5) ◽  
pp. 431-436 ◽  
Author(s):  
Sasa Grgov ◽  
Vuka Katic ◽  
Miljan Krstic ◽  
Aleksandar Nagorni ◽  
Biljana Radovanovic-Dinic ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Malt Lymphoma ◽  
Cell Lymphoma ◽  
Eradication Therapy ◽  
Large Cell ◽  
Gastric Malt Lymphoma ◽  
Low Grade ◽  
Diffuse Large Cell Lymphoma ◽  
Large Cell Lymphoma ◽  
H Pylori

Background/Aim. Lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) of the stomach usually occurs as a consequence of Helicobacter pylori (H. pylori) infection. The aim of this study was to investigate the long-term effect of treatment of low-grade gastric MALT lymphoma with the H. pylori eradication method. Methods. In the period 2002-2012 in 20 patients with dyspepsia, mean age 55.1 years, the endoscopic and histologic diagnosis of gastric MALT lymphoma in the early stages were made. Histological preparations of endoscopic biopsy specimens were stained with hematoxyllineosin (HE), histochemical and immunohistochemical methods. Results. Endoscopic findings of gastritis were documented in 25% of the patients, and 75% of the patients had hypertrophic folds, severe mucosal hyperemia, fragility, nodularity, exulcerations and rigidity. Histopathologically, pathognomonic diagnostic criterion were infiltration and destruction of glandular epithelium with neoplastic lymphoid cells, the so-called lymphoepithelial lesions. In all 20 patients H. pylori was verified by rapid urease test and Giemsa stain. After the triple eradication therapy complete remission of MALT lymphoma was achieved in 85% of the patients, with no recurrence of lymphoma and H. pylori infection in the average follow-up period of 48 months. In 3 (15%) of the patients, there was no remission of MALT lymphoma 12 months after the eradication therapy. Of these 3 patients 2 had progression of MALT lymphoma to diffuse large-cell lymphoma. Conclusion. Durable complete re-mission of low-grade gastric MALT lymphoma is achieved in a high percentage after eradication of H. pylori infection, thus preventing the formation of diffuse large-cell lymphoma and gastric adenocarcinoma.

scholarly journals The Helicobacter pylori CagY Protein Drives Gastric Th1 and Th17 Inflammation and B Cell Proliferation in Gastric MALT Lymphoma

2021 ◽  
Vol 22 (17) ◽  
pp. 9459
Author(s):  
Chiara Della Bella ◽  
Maria Felicia Soluri ◽  
Simone Puccio ◽  
Marisa Benagiano ◽  
Alessia Grassi ◽  
...  
Keyword(s):  
Cell Proliferation ◽  
Helicobacter Pylori ◽  
T Cell ◽  
B Cell ◽  
Malt Lymphoma ◽  
Chronic Gastritis ◽  
Gastric Malt Lymphoma ◽  
Low Grade ◽  
Cell Clones ◽  
H Pylori

Background: the neoplastic B cells of the Helicobacter pylori-related low-grade gastric mucosa-associated lymphoid tissue (MALT) lymphoma proliferate in response to H. pylori, however, the nature of the H. pylori antigen responsible for proliferation is still unknown. The purpose of the study was to dissect whether CagY might be the H. pylori antigen able to drive B cell proliferation. Methods: the B cells and the clonal progeny of T cells from the gastric mucosa of five patients with MALT lymphoma were compared with those of T cell clones obtained from five H. pylori–infected patients with chronic gastritis. The T cell clones were assessed for their specificity to H. pylori CagY, cytokine profile and helper function for B cell proliferation. Results: 22 of 158 CD4+ (13.9%) gastric clones from MALT lymphoma and three of 179 CD4+ (1.7%) clones from chronic gastritis recognized CagY. CagY predominantly drives Interferon-gamma (IFN-γ) and Interleukin-17 (IL-17) secretion by gastric CD4+ T cells from H. pylori-infected patients with low-grade gastric MALT lymphoma. All MALT lymphoma-derived clones dose dependently increased their B cell help, whereas clones from chronic gastritis lost helper activity at T-to-B-cell ratios greater than 1. Conclusion: the results obtained indicate that CagY drives both B cell proliferation and T cell activation in gastric MALT lymphomas.

Alcohol Drinking, Smoking, Past History of Gastroduodenal Ulcer, Height, and Risk of API2-MALT1 Fusion Positive and Negative Gastric MALT Lymphoma Among Japanese.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 5010-5010
Author(s):  
Takakazu Kawase ◽  
Keitaro Matsuo ◽  
Tsuneya Nakamura ◽  
Junya Kanda ◽  
Hidemi Ito ◽  
...  
Keyword(s):  
B Cell ◽  
Malt Lymphoma ◽  
Alcohol Intake ◽  
Past History ◽  
Gastroduodenal Ulcer ◽  
B Cell Lymphoma ◽  
Gastric Malt Lymphoma ◽  
Low Grade ◽  
History Of ◽  
H Pylori

Abstract Abstract 5010 Extranodal marginal zone B-cell lymphoma of mucosaassociated lymphoid tissue (MALT Lymphoma) is low-grade extranodal lymphoma, and it comprises 7-8% of all B cell lymphomas, and up to 50% of primary gastric lymphoma. It is known that a preexisting chronic inflammation such as Helicobactoer pylori (H. pylori) gastritis can influence its development, however, some MALT lymphomas with no evidence of such inflammation are found. Protracted remissions may be induced by H. pylori eradication therapy, but cases with t(11;18)(q21;q21) appear to be resistant to the therapy. t(11;18)(q21;q21) has been observed in 25-50% of the cases and API2 at 11q21 and MALT1 at 18q21 are fused as a result of this translocation. Thus, API2-MALT1 fusion positive and negative MALT lymphoma may have different etiology, although histological features of both MALT lymphomas have not been clearly delineated. To clarify differences of epidemiological features between API2-MALT1 fusion positive and negative gastric MALT lymphoma, we conducted a case-control study of 61 newly and histologically diagnosed gastric MALT lymphoma cases (14 of API2-MALT1 fusion positive cases and 47 of negative cases) and 610 age and sex frequency-matched non-cancer controls. API2-MALT1 fusion was evaluated by a multiplex reverse transcription-polymerase chain reaction using formalin-fixed, paraffinembedded sections. We evaluated the association with alcohol intake (never drinkers, occasional drinkers, and frequent but moderate (<50 g/day of alcohol) and frequent and heavy drinkers (≥50 g/day of alcohol)), smoking (<5, 5-19, 20-39, ≥40 pack-years), past history of gastroduodenal ulcer, height, and risk of API2-MALT1 fusion positive and negative gastric MALT lymphoma. Odds ratios (ORs) with 95% confidence intervals (CIs) were estimated using multinomial logistic models adjusted for potential confounders. A significant association was observed between past history of gastroduodenal ulcer and the risk only among fusion negative cases, with ORs of subjects with past history of gastroduodenal ulcer of 2.86 (95% CI, 1.31-6.14; p = 0.008) compared to subjects without past history of gastroduodenal ulcer. No clear associations were observed between alcohol intake, smoking, height and the risk irrespective of positivity of API2-MALT1 fusion. These findings suggest that past history of gastroduodenal ulcer, which may be due to H.pylori infection, does not associated with the carcinogenic mechanism of API2-MALT1 fusion positive gastric MALT lymphoma, and fusion positive and negative tumors have different etiology. Further investigations using large data sets are needed. Disclosures No relevant conflicts of interest to declare.

Sign in / Sign up

Export Citation Format

Share Document