T(11;18) is a marker for all stage gastric MALT lymphomas that will not respond to H. pylori eradication.
OBJECTIVE
Eradication of Helicobacter pylori leads to cure of gastric mucosa-associated lymphoid tissue (MALT) lymphoma in 75% of localized cases. However, prolonged follow-up is necessary to determine whether a lymphoma responds to therapy. In a small series of cases, we showed that t(11;18)(q21;q21)-positive MALT lymphomas failed to respond to H. pylori eradication. The present study aimed to verify this finding in a large cohort and confirm whether the translocation predicts the response of stage I(E) tumors, for which clinical staging has little prognostic value.


METHODS
A total of 111 patients with H. pylori-positive gastric MALT lymphoma treated with antibiotics were studied. Clinical staging was undertaken before therapy. The response of lymphoma to H. pylori eradication was determined by histologic examination of gastric biopsy specimens. Diagnostic biopsy specimens were analyzed for t(11;18)(q21;q21) by reverse-transcription polymerase chain reaction of the API2-MALT1 transcript.


RESULTS
Forty-seven of the 48 patients who showed complete regression had lymphoma at stage I(E), whereas 43 of the 63 nonresponsive cases were at stage I(E) and the remaining cases at stage II(E) or above. t(11;18)(q21;q21) was detected in 2 of 48 complete-regression cases, and these positive cases showed relapse of lymphoma in the absence of H. pylori reinfection. In contrast, the translocation was present in 42 of the 63 nonresponsive cases, including 26 of 43 (60%) at stage I(E).


CONCLUSIONS
t(11;18)(q21;q21)-positive gastric MALT lymphomas, including those at stage I(E), do not respond to H. pylori eradication. Detection of the translocation should help the clinical management of patients with gastric MALT lymphoma.
Liu
Hongxiang
H
Department of Histopathology, University College London, London, England.
Ye
Hongtao
H
Ruskone-Fourmestraux
Agnes
A
De Jong
Daphne
D
Pileri
Stefano
S
Thiede
Christian
C
Lavergne
Anne
A
Boot
Henk
H
Caletti
Giancarlo
G
Wündisch
Thomas
T
Molina
Thierry
T
Taal
Babs G
BG
Elena
Sabattini
S
Thomas
Togliani
T
Zinzani
Pier Luigi
PL
Neubauer
Andreas
A
Stolte
Manfred
M
Hamoudi
Rifat A
RA
Dogan
Ahmet
A
Isaacson
Peter G
PG
Du
Ming-Qing
MQ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002880:Chromosomes, Human, Pair 11; D002887:Chromosomes, Human, Pair 18; D005260:Female; D016481:Helicobacter Infections / Q000150:complications / Q000188:drug therapy*; D016480:Helicobacter pylori / Q000187:drug effects*; D006801:Humans; D018442:Lymphoma, B-Cell, Marginal Zone / Q000188:drug therapy / Q000209:etiology / Q000235:genetics*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D015514:Oncogene Proteins, Fusion / Q000235:genetics; D013274:Stomach Neoplasms / Q000188:drug therapy / Q000209:etiology / Q000235:genetics*; D014178:Translocation, Genetic
C415943:API2-MALT1 fusion protein, human; D015514:Oncogene Proteins, Fusion