Association between Helicobacter pylori infection and MALT-type lymphoma of the ocular adnexa: clinical and therapeutic implications.
BACKGROUND
The prevalence and the clinical impact of gastric Helicobacter pylori (Hp) infection, as well as its possible correlation with Chlamydia psittaci (Cps) infection and the lymphoma regression rate produced by Hp eradicating antibiotic therapy were investigated in patients with MALT-type lymphoma of the ocular adnexa (OAL).


METHODS
During staging, the presence of gastric Hp infection was assessed by gastroscopy and multiple biopsies in 31 OAL patients. Immediately after, Hp-positive patients were treated with eradicating antibiotic therapy, alone or associated with other therapies.


RESULTS
Gastric Hp infection was detected in 10 (32%) patients; this feature did not correlate with patients' characteristics and disease. Four Hp-positive patients were treated with Hp-eradicating antibiotics therapy as exclusive strategy (assessable for response), none of them showed lymphoma regression. Conversely, 6 Hp-positive patients were treated with antibiotic therapy concurrently with other therapies, achieving lymphoma regression in all cases. Three Hp-positive patients with Cps-positive lymphoma were treated with doxycycline at relapse, resulting in two CR and one PR, which lasted 24+, 20+, and 18+ months, respectively. One of these patients achieved a CR after doxycycline despite the chronic persistence of Hp infection, whereas Cps-eradication was confirmed in the analysis of PBMC samples.


CONCLUSIONS
Gastric Hp infection, even if common among OAL patients, does not influence clinical presentation. Hp-eradicating antibiotic therapy is not active against OAL. Cps-eradicating antibiotic therapy with doxycycline induces lymphoma remission irrespectively of the persistence of Hp infection.
Ferreri
Andrés Jm
AJ
Medical Oncology Unit, San Raffaele H Scientific Institute, Milan, Italy.
Ponzoni
Maurilio
M
Viale
Edi
E
Guidoboni
Massimo
M
Conciliis
Carlo De
CD
Resti
Antonio Giordano
AG
Politi
Letterio
L
Lettini
Antonia Anna
AA
Sacchetti
Federico
F
Dognini
Giuseppina
G
Dolcetti
Riccardo
R
Doglioni
Claudio
C
D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003229:Conjunctival Diseases / Q000382:microbiology*; D018572:Disease-Free Survival; D004318:Doxycycline / Q000494:pharmacology; D005260:Female; D005773:Gastroscopy; D016481:Helicobacter Infections / Q000150:complications* / Q000188:drug therapy; D016480:Helicobacter pylori / Q000302:isolation & purification*; D006801:Humans; D018442:Lymphoma, B-Cell, Marginal Zone / Q000382:microbiology*; D008297:Male; D008875:Middle Aged; D009916:Orbital Diseases / Q000382:microbiology*; D016879:Salvage Therapy; D013274:Stomach Neoplasms / Q000382:microbiology*; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D004318:Doxycycline