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, et al. (2010). Effects of Helicobacter pylori eradication on early-stage gastric mucosa associated lymphoid tissue lymphoma. CLINICAL GASTROENTEROLOGY AND HEPATOLOGY, 8 fasc. 2, 105-110 [10.1016/j.cgh.2009.07.017].
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.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
