Helicobacter pylori eradication therapy is effective in the treatment of early-stage H pylori–positive gastric diffuse large B-cell lymphomas

• Published in: Blood Vol. 119; no. 21; pp. 4838 - 4844
• Main Authors: Kuo, Sung-Hsin, Yeh, Kun-Huei, Wu, Ming-Shiang, Lin, Chung-Wu, Hsu, Ping-Ning, Wang, Hsiu-Po, Chen, Li-Tzong, Cheng, Ann-Lii
• Format: Journal Article
• Language: English
• Published: Washington, DC Elsevier Inc 24-05-2012; Americain Society of Hematology
• Subjects: Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents - therapeutic use; Bacterial diseases; Bacterial diseases of the digestive system and abdomen; Biological and medical sciences; Female; Helicobacter Infections - complications; Helicobacter Infections - drug therapy; Helicobacter pylori; Helicobacter pylori - drug effects; Helicobacter pylori - growth & development; Hematologic and hematopoietic diseases; Human bacterial diseases; Humans; Infectious diseases; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Lymphoma, B-Cell, Marginal Zone - drug therapy; Lymphoma, B-Cell, Marginal Zone - etiology; Lymphoma, B-Cell, Marginal Zone - pathology; Lymphoma, Large B-Cell, Diffuse - drug therapy; Lymphoma, Large B-Cell, Diffuse - etiology; Lymphoma, Large B-Cell, Diffuse - pathology; Male; Medical sciences; Middle Aged; Multicenter Studies as Topic; Neoadjuvant Therapy; Neoplasm Staging; Retrospective Studies; Stomach Neoplasms - drug therapy; Stomach Neoplasms - etiology; Stomach Neoplasms - pathology; Treatment Outcome; Young Adult; Stomach; Spirillales; Hematology; Digestive system; Spirillaceae; Early stage; B cell neoplasm; Malignant hemopathy; Non Hodgkin lymphoma; Eradication; Infection; Treatment; Helicobacter pylori; Efficiency; Lymphoproliferative syndrome; Bacteriosis; Bacteria; Diffuse large B cell lymphoma; Cancer
• ISSN: 0006-4971; 1528-0020; 1528-0020
• DOI: 10.1182/blood-2012-01-404194

An explorative study evaluates the efficacy of Helicobacter pylori (HP) eradication (HPE) therapy on early-stage gastric diffuse large B-cell lymphomas (DLBCLs) without features of mucosa-associated lymphoid tissue (MALT), the pure (de novo) DLBCLs, in comparison with its efficacy on high-grade transformed gastric MALT lymphomas, the DLBCL(MALT). In total, 50 patients of stage IE/IIE1 HP-positive gastric DLBCLs with frontline HPE treatment were included. HP infection was successfully eradicated in 100% (16/16) of the pure (de novo) DLBCL patients and 94.1% (32/34) of the DLBCL(MALT) patients. In total, 68.8% (11/16) of pure (de novo) DLBCL patients and 56.3% (18/32) of DLBCL(MALT) patients achieved complete pathologic remission (pCR) after HPE therapy. The median time to pCR was 2.1 months (95% confidence interval, 0.6%-3.7%) for pure (de novo) DLBCLs and 5.0 months (95% confidence interval, 2.8%-7.5%; P = .024) for DLBCL(MALT). At a median follow-up of 7.7 years, all patients with pCR after HPE therapy were alive and free of lymphomas, except for one patient with pure (de novo) DLBCL who died of lung cancer. Similar to DLBCL(MALT), a substantial portion of early-stage HP-positive gastric pure (de novo) DLBCLs remains HP-dependent and responds to antibiotic treatment. Prospective studies to validate the findings are warranted.