Regression of primary gastric lymphoma of mucosa-associated lymphoid tissue type after cure of Helicobacter pylori infection. MALT Lymphoma Study Group

Lancet. 1995 Jun 24;345(8965):1591-4. doi: 10.1016/s0140-6736(95)90113-2.

Abstract

Lymphoma of gastric-mucosa-associated lymphatic tissue (MALT) type has been linked to infection with Helicobacter pylori. We investigated the effect on MALT lymphoma of eradicating H pylori infection. 33 patients with primary gastric low-grade MALT lymphoma associated with H pylori gastritis were treated with omeprazole (120 mg daily) and amoxycillin (2.25 g daily) for 14 days to eradicate H pylori. In addition to histology, PCR was used to examine proliferation of monoclonal B cells before treatment and during follow-up. All patients had at least two post-treatment examinations, and all became negative for H pylori, 2 after a second treatment course. On histology, 23 (70%) patients showed complete regression and 4 (12%) partial regression of lymphoma. 6 (18%) patients had no change after cure of H pylori infection. 1 was treated with chemotherapy. Of 5 treated surgically, 4 were found to have high-grade B-cell lymphoma on histology of the resected stomach and 1 a high-grade T-cell lymphoma. PCR showed complete disappearance of monoclonal B cells after cure of H pylori infection in 13 of 16 patients investigated. During median follow-up of 1 year no relapse of MALT lymphoma occurred. Low-grade primary gastric MALT lymphoma can completely regress after eradication of H pylori infection. However, longer follow-up is needed to clarify whether the remission is lasting.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Amoxicillin / therapeutic use
  • Female
  • Follow-Up Studies
  • Gastritis / complications
  • Gastritis / drug therapy*
  • Gastritis / microbiology
  • Helicobacter Infections / complications
  • Helicobacter Infections / drug therapy*
  • Helicobacter pylori*
  • Humans
  • Lymphoma, B-Cell, Marginal Zone / drug therapy
  • Lymphoma, B-Cell, Marginal Zone / microbiology*
  • Lymphoma, B-Cell, Marginal Zone / pathology
  • Male
  • Middle Aged
  • Omeprazole / therapeutic use
  • Stomach Neoplasms / drug therapy
  • Stomach Neoplasms / microbiology*
  • Stomach Neoplasms / pathology

Substances

  • Amoxicillin
  • Omeprazole