Authors: F Agresta G Trentin P Mainente D Della Libera A Bianco L Salvagno
Publish Date: 2014/04/21
Volume: 14, Issue: 12, Pages: 1153-1155
Abstract
Background Findings have demonstrated the close association between primary gastric Bcell lymphomas originating from mucosaassociated lymphoid tissue MALT and Helicobacter pylori HP infection with their regression after an HP eradication therapy in up to 70 of the cases Endoscopicbiopsy diagnosis and endoscopic ultrasound are of major importance as decisive prognostic factors and therapeutic determinants Objectives We report 3 years of experience and followup evaluation in the management of MALT lymphomas We also describe the guidelines strategy therapy used in our institutionMethods Since July 1996 nine patients with a histologic diagnosis of lowgrade HPpositive MALT gastric lymphomas have been followed up All patients had stage IE lymphomas according to Musshoff classification Eradication of HP was performed with triple therapy amoxycillin clarithromycin and omeprazole using over a 14day period The patients were seen for endoscopic followup assessment after 3 6 9 and 15 months then twice a year The actual median followup time was 304 months range 16–38 monthsResults All the patients are now free of disease and asymptomatic We have registered two cases of HP relapse both after 1year followup evaluation positively treated with the same triple therapy and three cases of disease relapse treated with singledose chemotherapy plus radiotherapy in one patientConclusions In our experience the eradication of HP appears to be effective and we consider it the first therapeutic option in patients with stage IE gastric lowgrade MALT lymphoma although longterm results are still needed Prolonged followup evaluation particularly by endoscopy is necessary and feasible in our experience to determine whether these remissions are longlasting We recommend that HP be eradicated in these lymphomas before referral to other standard treatment
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