Successful antibiotic treatment of Helicobacter pylori negative gastric MALT lymphomas

Markus Raderer ^1*, Berthold Streubel ¹, Stefan Wöhrer ¹, Michael Häfner ¹ and Andreas Chott ¹

¹ University of Vienna, Austria

^* To whom correspondence should be addressed. E-mail: markus.raderer{at}meduniwien.ac.at.

Accepted 28 October 2005

Abstract

Background and aims: The role of antibiotic treatment in early stage gastric MALT lymphoma not associated with Helicobacter pylori (HP) infection has not been investigated.

Patients and methods: Six patients with localized gastric MALT lymphoma underwent antibiotic treatment with clarithromycin, metronidazole and pantoprazole. Staging including endosonography plus gastroscopy, CT of thorax and abdomen, colonoscopy, MRI of salivary glands and bone marrow biopsy were performed to rule out distant spread of the disease. In addition, MALT-specific genetic changes including reverse-transcriptase PCR (RT-PCR) for t (11;18)(q21;q21) were tested in all patients. HP- infection was ruled out by histology, urease breath test, serology and stool-antigen testing.

Results: All 6 patients had MALT lymphoma restricted to the stomach, and no evidence of infection with HP was found. Only one tested positive for t(11;18) (q21;q21), while the remaining five displayed no genetic aberrations. Following antibiotic treatment, endoscopic controls were performed every 3 months. Five patients responded with lymphoma-regression between 3 - 9 months following antibiotic treatment (one partial remission and four complete responses). One patient had stable disease for 12 months and was then referred to chemotherapy.

Conclusions: Patients with early stage gastric MALT lymphoma negative for HP might still benefit from antibiotic treatment as sole treatment modality.

Keywords: Helicobacter pylori, antibiotics, gastric lymphoma

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