title: Association between Helicobacter pylori infection and MALT-type lymphoma of the ocular adnexa: clinical and therapeutic implications.
abstract: 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.
authors.affiliation: Medical Oncology Unit, San Raffaele H Scientific Institute, Milan, Italy.
authors.forename: Andrés Jm
authors.initials: AJ
authors.lastname: Ferreri
authors.forename: Maurilio
authors.initials: M
authors.lastname: Ponzoni
authors.forename: Edi
authors.initials: E
authors.lastname: Viale
authors.forename: Massimo
authors.initials: M
authors.lastname: Guidoboni
authors.forename: Carlo De
authors.initials: CD
authors.lastname: Conciliis
authors.forename: Antonio Giordano
authors.initials: AG
authors.lastname: Resti
authors.forename: Letterio
authors.initials: L
authors.lastname: Politi
authors.forename: Antonia Anna
authors.initials: AA
authors.lastname: Lettini
authors.forename: Federico
authors.initials: F
authors.lastname: Sacchetti
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Dognini
authors.forename: Riccardo
authors.initials: R
authors.lastname: Dolcetti
authors.forename: Claudio
authors.initials: C
authors.lastname: Doglioni
mesh_terms: 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
chemical_list: D000900:Anti-Bacterial Agents; D004318:Doxycycline