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.
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.
Aull
Meredith J
MJ
Division of Nephrology and Hypertension, Department of Internal Medicine, University of Cincinnati, Cincinnati, OH 45267, USA.
Buell
Joseph F
JF
Peddi
V R
VR
Trofe
Jennifer
J
Beebe
Thomas M
TM
Hanaway
Michael J
MJ
Roy-Chaudhury
Prabir
P
Alloway
Rita R
RR
First
M Roy
MR
Woodle
E Steve
ES
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*