title: MALToma: a Helicobacter pylori-associated malignancy in transplant patients: a report from the Israel Penn International Transplant Tumor Registry with a review of published literature.
abstract: BACKGROUND
  Mucosa-associated lymphoid tissue lymphoma (MALToma) is a Helicobacter pylori-related tumor of B-cell origin, the malignant potential for which remains to be defined in immunosuppressed patients.
  
  
  METHODS
  Review of the Israel Penn International Transplant Tumor Registry identified six cases of gastric MALToma. Patient demographics, management, and outcomes were compared and published literature was reviewed.
  
  
  RESULTS
  MALToma developed in six transplant recipients (three kidney, two heart, one kidney-pancreas). All were treated with immunosuppression minimization and therapy for H. pylori, resulting in disease regression in five patients. One patient developed progression to high-grade MALToma despite documented H. pylori eradication, required surgery and chemotherapy, and died, with significant disease at autopsy.
  
  
  CONCLUSIONS
  Treatment of MALToma with immunosuppression minimization and anti-H. pylori therapy results in a majority of patients becoming disease free. Observation of malignant degeneration into an aggressive, high-grade lymphoma in one patient indicates the malignant potential. Diligent follow-up of these patients with endoscopy and biopsy is therefore indicated.
authors.affiliation: Division of Nephrology and Hypertension, Department of Internal Medicine, University of Cincinnati, Cincinnati, OH 45267, USA.
authors.forename: Meredith J
authors.initials: MJ
authors.lastname: Aull
authors.forename: Joseph F
authors.initials: JF
authors.lastname: Buell
authors.forename: V R
authors.initials: VR
authors.lastname: Peddi
authors.forename: Jennifer
authors.initials: J
authors.lastname: Trofe
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Beebe
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Hanaway
authors.forename: Prabir
authors.initials: P
authors.lastname: Roy-Chaudhury
authors.forename: Rita R
authors.initials: RR
authors.lastname: Alloway
authors.forename: M Roy
authors.initials: MR
authors.lastname: First
authors.forename: E Steve
authors.initials: ES
authors.lastname: Woodle
mesh_terms: D000328:Adult; D005260:Female; D016027:Heart Transplantation / Q000009:adverse effects; D016481:Helicobacter Infections / Q000150:complications*; D016480:Helicobacter pylori; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects; D016031:Liver Transplantation / Q000009:adverse effects; D018442:Lymphoma, B-Cell, Marginal Zone / Q000209:etiology*; D008875:Middle Aged; D016377:Organ Transplantation / Q000009:adverse effects*