BACKGROUND & AIMS: Different remission rates of gastric low-grade, B-cell, mucosa–associated lymphoid tissue (MALT) lymphoma have been reported after Helicobacter pylori eradication. We assessed the long-term remission and relapse rates of early stage MALT lymphoma in patients treated only by H pylori eradication and identified factors that might predict outcome. METHODS: This systematic review analyzed data from 32 studies, including 1408 patients. RESULTS: The MALT lymphoma emission rate was 77.5% (95% confidence interval, 75.379.7), and was significantly higher in patients with stage I than stage II1 lymphoma (78.4% vs 55.6%; P .0003) and in Asian than in Western groups (84.1% vs 73.8%; P .0001). Neoplasia confined to the submucosa regressed more frequently than that with deeper invasion (82.2% vs 54.5%; P .0001); patients with lymphoma localized to the distal stomach experienced regression more frequently than those with lymphoma of the proximal stomach (91.8% vs 75.7%; P .0037). The remission rate was higher among patients without the AP12–MALT1 translocation than in those with this translocation (78% vs 22.2%; P .0001). In an analysis of data from 994 patients, 7.2% experienced lymphoma relapse during 3253 patient-years of follow-up evaluation, with a yearly recurrence rate of 2.2%. Infection and lymphoma were cured by additional eradication therapy in all patients with H pylori recurrence (16.7%). Five (0.05%) of the patients initially cured of lymphoma developed high-grade lymphoma within 6 to 25 months of therapy. CONCLUSIONS: H pylori eradication is effective in treating approximately 75% of patients with early stage gastric lymphoma. Long-term follow-up evaluation of these patients is needed to detect early lymphoma relapse or progression.

Effects of Helicobacter pylori eradication on early-stage gastric mucosa associated lymphoid tissue lymphoma.

VAIRA, BERARDINO
2010

Abstract

BACKGROUND & AIMS: Different remission rates of gastric low-grade, B-cell, mucosa–associated lymphoid tissue (MALT) lymphoma have been reported after Helicobacter pylori eradication. We assessed the long-term remission and relapse rates of early stage MALT lymphoma in patients treated only by H pylori eradication and identified factors that might predict outcome. METHODS: This systematic review analyzed data from 32 studies, including 1408 patients. RESULTS: The MALT lymphoma emission rate was 77.5% (95% confidence interval, 75.379.7), and was significantly higher in patients with stage I than stage II1 lymphoma (78.4% vs 55.6%; P .0003) and in Asian than in Western groups (84.1% vs 73.8%; P .0001). Neoplasia confined to the submucosa regressed more frequently than that with deeper invasion (82.2% vs 54.5%; P .0001); patients with lymphoma localized to the distal stomach experienced regression more frequently than those with lymphoma of the proximal stomach (91.8% vs 75.7%; P .0037). The remission rate was higher among patients without the AP12–MALT1 translocation than in those with this translocation (78% vs 22.2%; P .0001). In an analysis of data from 994 patients, 7.2% experienced lymphoma relapse during 3253 patient-years of follow-up evaluation, with a yearly recurrence rate of 2.2%. Infection and lymphoma were cured by additional eradication therapy in all patients with H pylori recurrence (16.7%). Five (0.05%) of the patients initially cured of lymphoma developed high-grade lymphoma within 6 to 25 months of therapy. CONCLUSIONS: H pylori eradication is effective in treating approximately 75% of patients with early stage gastric lymphoma. Long-term follow-up evaluation of these patients is needed to detect early lymphoma relapse or progression.
Zullo A; Hassan C; Cristofari F; Andriani A; De Francesco V; Ierardi E; Tomao S; Stolte M; Morini S; Vaira D.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11585/83324
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