Complete remission of primary high-grade B-cell gastric lymphoma after cure of Helicobacter pylori infection.
OBJECTIVE
Treatment of low-grade gastric mucosa-associated lymphoid tissue lymphoma by eradication of Helicobacter pylori is reported to result in complete lymphoma remission in approximately 75% of cases. The effect that cure of the infection has on the course of a primary high-grade gastric lymphoma is largely uncertain. The aim of this study was to report the effect of cure of H pylori infection exerted in patients with high-grade B-cell gastric lymphoma.


METHODS
Eight patients (4 males and 4 females; age range, 26 to 85 years) with H pylori infection and high-grade lymphoma received eradication therapy before planned treatment. The effect of H pylori eradication on the course of high-grade lymphoma was assessed by analysis of surgical specimens (n = 2) or endoscopic biopsies (n = 6).


RESULTS
H pylori eradication was successful in all patients and led to complete remission of the lymphoma in seven patients. One patient has experienced partial remission. Two patients were referred to surgery, one of whom (stage II(1E)) had lymph node involvement, and the histologic work-up of the resected stomach revealed residual infiltrates of a low-grade lymphoma, which prompted consolidation chemotherapy. In one patient (initially stage I(1E)), abdominal lymphoma developed 6 months after eradication therapy, which regressed completely after chemotherapy. In four patients, no further treatment was given. Six patients continue in complete remission (range, 6 to 66 months).


CONCLUSIONS
Primary high-grade B-cell gastric lymphoma in stages I(E) through II(E1) associated with H pylori may regress completely after successful cure of the infection. Prospective trials are needed to investigate this treatment in larger numbers of patients.
Medical Department I, Technical University of Dresden, Dresden, Germany. andrea.morgner@t-online.de
A
A
Morgner
S
S
Miehlke
W
W
Fischbach
W
W
Schmitt
H
H
Müller-Hermelink
A
A
Greiner
C
C
Thiede
J
J
Schetelig
A
A
Neubauer
M
M
Stolte
G
G
Ehninger
E
E
Bayerdörffer
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000658:Amoxicillin / Q000627:therapeutic use; D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D002471:Cell Transformation, Neoplastic; D005260:Female; D016481:Helicobacter Infections / Q000150:complications* / Q000188:drug therapy*; D016480:Helicobacter pylori; D006801:Humans; D016393:Lymphoma, B-Cell / Q000188:drug therapy / Q000382:microbiology* / Q000473:pathology; D018442:Lymphoma, B-Cell, Marginal Zone / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy / Q000382:microbiology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009853:Omeprazole / Q000627:therapeutic use; D010406:Penicillins / Q000627:therapeutic use; D012074:Remission Induction / Q000379:methods; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000188:drug therapy / Q000382:microbiology* / Q000473:pathology
D000897:Anti-Ulcer Agents; D010406:Penicillins; D000658:Amoxicillin; D009853:Omeprazole