Helicobacter pylori eradication therapy in gastric high grade non Hodgkin's lymphoma (NHL).
BACKGROUND
Primary gastric low-grade lymphoma of the mucosa associated lymphoid tissue (MALT) develops on the background of a chronic Helicobacter pylori (H. pylori) infection. Stable remissions can be induced by H. pylori eradication therapy as shown in clinical trials. In 8 cases of high-grade gastric lymphomas remissions after H. pylori eradication were observed retrospectively.


OBJECTIVE
We started a pilot-trial to investigate the value of H. pylori eradication therapy in early gastric high-grade B-cell lymphoma prospectively.


METHODS
So far, two H. pylori positive patients with high-grade B-cell lymphoma of the stomach stage Ann Arbor I E are included. They received a triple eradication-therapy (Clarithromycin 500 mg/d, Metronidazol 800 mg/d and Omeprazol 40 mg/d) for 7 days. Endoscopic controls are preformed every 4 weeks.


RESULTS
Both patients became H. pylori negative after eradication therapy. One patient achieved complete remission (CR) 38 days after eradication. The continuous complete remission lasts now for 170 days. The second patient received only a partial remission (PR) 4 weeks after eradication and showed a slight progress 4 weeks later. He presently receives chemotherapy (CHOP).


CONCLUSIONS
Patients with early high-grade gastric B-cell lymphomas should receive H. pylori eradication only within clinical trials. It seems to be possible to induce remissions of early high-grade gastric B-cell lymphomas with exclusive H. pylori eradication therapy. The stability of remission remains to be unclear and should be evaluated by following up the patients closely.
Alpen
B
B
Department of Hematology, Oncology, Immunology, Hospital of the Philipps-University Marburg, Germany.
Röbbecke
J
J
Wündisch
T
T
Stolte
M
M
Neubauer
A
A
D000368:Aged; D000897:Anti-Ulcer Agents / Q000627:therapeutic use*; D017291:Clarithromycin / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D004359:Drug Therapy, Combination / Q000627:therapeutic use*; D005756:Gastritis / Q000150:complications / Q000188:drug therapy*; D016481:Helicobacter Infections / Q000150:complications / Q000188:drug therapy*; D016480:Helicobacter pylori / Q000187:drug effects* / Q000472:pathogenicity; D006801:Humans; D018442:Lymphoma, B-Cell, Marginal Zone / Q000150:complications* / Q000473:pathology / Q000628:therapy; D008228:Lymphoma, Non-Hodgkin / Q000150:complications* / Q000473:pathology / Q000628:therapy; D008795:Metronidazole / Q000627:therapeutic use*; D009853:Omeprazole / Q000627:therapeutic use*; D011446:Prospective Studies; D012074:Remission Induction; D013274:Stomach Neoplasms / Q000150:complications* / Q000473:pathology / Q000628:therapy; D016896:Treatment Outcome
D000897:Anti-Ulcer Agents; D008795:Metronidazole; D017291:Clarithromycin; D009853:Omeprazole