Antibiotic treatment is not effective in patients infected with Helicobacter pylori suffering from extragastric MALT lymphoma.
OBJECTIVE
Apart from anecdotal reports implicating Helicobacter pylori (HP) in the development of extragastric mucosa associated lymphoid tissue (MALT) lymphoma, no large scale prospective studies have been performed on this topic.


METHODS
A total of 77 patients with extragastric MALT lymphoma were prospectively studied. The presence or absence of HP was tested by histology, urease breath test, and serology. Patients were also tested for hepatitis A, B, and C and autoimmune conditions along with assessment of MALT lymphoma-specific genetic changes.


RESULTS
Evidence for infection with HP was present in 35 of 77 patients (45%), and three of 75 patients tested (4%) were positive for hepatitis C and one for hepatitis B. All patients with HP-infection underwent eradication, 16 before initiation of further therapy. Apart from one patient with lymphoma involving parotid and colon, who achieved regression of the colonic lesions, none of these 16 patients showed regression of the lymphoma after a median follow-up of 14 months (range, 8 to 48+ months) before initiation of definitive treatment. No correlation between HP-status, localization, stage, autoimmune diseases, and genetic findings was seen.


CONCLUSIONS
In our series, HP-eradication was ineffective for treatment of extragastric MALT lymphomas. This finding, along with an infection rate of 45%-as could also be expected in the general Austrian population-suggests that HP does not play a role in the development of these lymphomas. Antibiotic treatment targeting HP should, therefore, be discouraged in patients with extragastric MALT lymphomas.
Department of Medicine I, Medical University Vienna,Vienna, Austria.
Birgit
B
Grünberger
Stefan
S
Wöhrer
Berthold
B
Streubel
Michael
M
Formanek
Ventzislav
V
Petkov
Andreas
A
Puespoek
Michael
M
Haefner
Michael
M
Hejna
Ulrich
U
Jaeger
Andreas
A
Chott
Markus
M
Raderer
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D005260:Female; D016481:Helicobacter Infections / Q000150:complications* / Q000188:drug therapy*; D006801:Humans; D018442:Lymphoma, B-Cell, Marginal Zone / Q000188:drug therapy* / Q000209:etiology / Q000382:microbiology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000209:etiology / Q000382:microbiology*; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents