title: Patients with Helicobacter pylori negative gastric marginal zone b-cell lymphoma (MZBCL) of MALT have a good prognosis.
abstract: BACKGROUND
  In current guidelines H. pylori eradication is recommended as first-line therapy in patients with gastric MALT lymphoma irrespective of stage and H. pylori status. However, data on treatment and clinical course of patients with H. pylori negative MALT lymphoma are rare.
  
  
  OBJECTIVE
  To evaluate therapeutical results in patients with H. pylori negative gastric MALT lymphoma.
  
  
  METHODS
  21 patients (13 male and 8 female; 63.9 years, range 43 - 80) with gastric MALT lymphoma were analysed retrospectively on the basis of medical reports in all cases and repeated outpatient visits at our center in 17 cases. H. pylori infection was excluded by negative histology, rapid urease test, or C13 urease breath test, and serology in all cases. Follow-up was 56.4 (5 - 142) months.
  
  
  RESULTS
  Ten of 21 patients were treated with H. pylori eradication, and four of them received no further therapy. The other six patients underwent surgery, chemotherapy, and radiation, after eradication therapy. Those eleven patients without H. pylori eradication received radiation (n = 3), chemotherapy (n = 1), PPIs (n = 2), no treatment (n = 4) as first-line and radiation (n = 2) as second-line therapy while initial therapy remained unknown in one case. 13 patients (61.9 %) reached complete remission of lymphoma, and seven patients (33.3 %) showed minimal histological residuals. Overall and disease-free survival was found in 95 % and 90 %, respectively.
  
  
  CONCLUSIONS
  Patients with H. pylori negative gastric MALT lymphoma have a good prognosis. We favor initial H. pylori eradication therapy and a watch-and-wait strategy in case of minimal histological residuals of MALT lymphoma. Non-responders to eradication therapy can be successfully treated by radiation and chemotherapy.
authors.affiliation: Department of Internal Medicine II, Klinikum Aschaffenburg, Aschaffenburg, Germany.
authors.forename: O
authors.initials: O
authors.lastname: Al-Taie
authors.affiliation: Department of Internal Medicine II, Klinikum Aschaffenburg, Aschaffenburg, Germany.
authors.forename: E
authors.initials: E
authors.lastname: Al-Taie
authors.affiliation: Department of Internal Medicine, Sankt Elisabeth Hospital, Guetersloh, Germany.
authors.forename: W
authors.initials: W
authors.lastname: Fischbach
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D059248:Chemoradiotherapy / Q000379:methods; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D016481:Helicobacter Infections / Q000150:complications* / Q000175:diagnosis / Q000628:therapy*; D016480:Helicobacter pylori; D006801:Humans; D018442:Lymphoma, B-Cell, Marginal Zone / Q000150:complications* / Q000175:diagnosis / Q000628:therapy*; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000628:therapy*; D013534:Survival; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents