Long-Term Results of Anti– Helicobacter pylori Therapy in Early-Stage Gastric High-Grade Transformed MALT Lymphoma

Autor: Gran Hum Chen, Chew Wun Wu, Ann-Lii Cheng, Wen-Ming Wang, Li-Tzong Chen, Hsiu-Po Wang, Ih-Jen Su, Jacqueline Whang-Peng, Chi Long Chen, Jaw-Town Lin, Chang Ming Jan, John Jen Tai, Tsang En Wang, Bor Shyang Sheu, Hong-Zen Yeh, Sheng-Shun Yang, Sung-Hsin Kuo
Rok vydání: 2005
Předmět:
Adult
Male
Cancer Research
medicine.medical_specialty
Time Factors
Taiwan
Severity of Illness Index
Gastroenterology
Disease-Free Survival
Drug Administration Schedule
Helicobacter Infections
Stomach Neoplasms
Metronidazole
hemic and lymphatic diseases
Internal medicine
Gastroscopy
Organometallic Compounds
Humans
Multicenter Studies as Topic
Medicine
Prospective Studies
Prospective cohort study
Aged
Helicobacter pylori
biology
business.industry
Gastric lymphoma
Amoxicillin
Cancer
MALT lymphoma
Lymphoma
B-Cell
Marginal Zone
Middle Aged
Anti-Ulcer Agents
medicine.disease
biology.organism_classification
Survival Analysis
Anti-Bacterial Agents
Lymphoma
Surgery
Treatment Outcome
Oncology
Disease Progression
Female
business
Mucosa-associated lymphoid tissue
Diffuse large B-cell lymphoma
Omeprazole
Zdroj: JNCI: Journal of the National Cancer Institute. 97:1345-1353
ISSN: 1460-2105
0027-8874
DOI: 10.1093/jnci/dji277
Popis: Background: Several independent clinical studies have reported that Helicobacter pylori eradication therapy could achieve complete remission in some patients with H. pylori – positive early-stage gastric mucosa – associated lymphoid tissue (MALT) lymphoma. Methods: To compare the long-term results of anti – H. pylori therapy in early-stage, gastric lowgrade and high-grade transformed MALT lymphoma, two multicenter prospective studies of anti – H. pylori therapy for early-stage gastric lymphoma conducted in Taiwan, one for low-grade MALT lymphoma, with 34 patients enrolled from March 1996 through April 1999, and one for high-grade transformed tumors (diffuse large B-cell lymphoma with features of MALT, DLBCL[MALT] lymphoma), with 24 patients enrolled since June 1995, were directly compared. In both studies, patients generally received 2 weeks of antibiotics and had multiple sequential follow-up endoscopic examinations until complete histologic remission (CR) or disease progression; patients were monitored through January 31, 2004. CR was defi ned as regression of lymphoid infi ltration to Wotherspoon’s score of 2 or less on all pathologic sections of endoscopic biopsy specimens. All statistical tests were two-sided. Results: The H. pylori – positive rate among the 34 low-grade patients was 94% (32 of 34). All 24 selected high-grade patients were H. pylori positive. H. pylori was eradicated in 97% (30 of 31) of evaluable H. pylori – positive low-grade patients and in 92% (22 of 24) of high-grade patients, which led to CR in 80% (24 of 30, 95% confi dence interval [CI] = 65% to 95%) and 64% (14 of 22, 95% CI = 42% to 86%) of patients, respectively. None of the fi ve patients who were either initially H. pylori negative or had persistent H. pylori infection after antibiotics achieved CR. After median follow-up of more than 5 years in complete responders, tumor recurrence was observed in three (13%) low-grade patients but not in high-grade patients. Conclusions: Anti – H. pylori therapy may be considered as one of the treatment options for early-stage H. pylori – positive gastric DLBCL(MALT), and large-scale prospective studies to validate its use as fi rst-line therapy for such tumors should be undertaken. [J Natl Cancer Inst 2005;97:1345 – 53]
Databáze: OpenAIRE
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