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Long term outcome of patients with gastric marginal zone B cell lymphoma of mucosa associated lymphoid tissue (MALT) following exclusive Helicobacter pylori eradication therapy: experience from a large prospective series | Gut
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Objective: To determine the long term outcome of patients undergoing exclusive H pylori eradication therapy. Design: A prospective series of patients with newly diagnosed marginal zone B cell lymphoma of MALT. Setting: Multicentre study in Germany and Austria. Patients: Ninety five patients; 90 of these (five lost to follow up) with a mean age of 54.3 (27–85) years were followed up for at least 12 months. Intervention: Complete staging work up revealing stage I disease and H pylori infection. Patients received triple therapy (OMC: omeprazole 20 mg twice daily, metronidazole 400 mg twice daily, and clarithromycin 250 mg twice daily; or OAC: omeprazole 20 mg twice daily, amoxycillin 1000 mg twice daily, and clarithromycin 500 twice daily) for one week. Results: Median follow up was 44.6 (12–89) months. H pylori was successfully eradicated in 88 patients (98%); in two patients eradication therapy failed. Long term outcome was characterised by complete regression of lymphoma in 56 patients (62%), minimal residual disease in 17 patients (18%), partial remission in 11 patients (12%), no change in four patients (4%), and progressive disease in two patients (2%). Four patients with complete remission relapsed after 6, 8, 8, and 15 months, one revealing reinfection by H pylori . Regression rate was higher in stage I1 disease compared with stage I2, as diagnosed by endoscopic ultrasound. Conclusion: The majority of patients with low grade gastric MALT lymphoma treated by exclusive H pylori eradication have a favourable long term outcome, offering a real chance of cure." /> <meta name="DC.Contributor" content="W Fischbach" /> <meta name="DC.Contributor" content="M-E Goebeler-Kolve" /> <meta name="DC.Contributor" content="B Dragosics" /> <meta name="DC.Contributor" content="A Greiner" /> <meta name="DC.Contributor" content="M Stolte" /> <meta name="article:published_time" content="2004-01-01" /> <meta name="article:section" content="Stomach" /> <meta name="citation_title" content="Long term outcome of patients with gastric marginal zone B cell lymphoma of mucosa associated lymphoid tissue (MALT) following exclusive Helicobacter pylori eradication therapy: experience from a large prospective series" /> <meta name="citation_abstract" lang="en" content="<p><b>Background:</b><i>Helicobacter pylori</i> plays a decisive role in the pathogenesis of gastric marginal zone B cell lymphoma of mucosa associated lymphoid tissue (MALT), and eradication therapy has become a widely accepted initial treatment of stage I disease.</p><p><b>Objective:</b> To determine the long term outcome of patients undergoing exclusive <i>H pylori</i> eradication therapy.</p><p><b>Design:</b> A prospective series of patients with newly diagnosed marginal zone B cell lymphoma of MALT.</p><p><b>Setting:</b> Multicentre study in Germany and Austria.</p><p><b>Patients:</b> Ninety five patients; 90 of these (five lost to follow up) with a mean age of 54.3 (27–85) years were followed up for at least 12 months.</p><p><b>Intervention:</b> Complete staging work up revealing stage I disease and <i>H pylori</i> infection. Patients received triple therapy (OMC: omeprazole 20 mg twice daily, metronidazole 400 mg twice daily, and clarithromycin 250 mg twice daily; or OAC: omeprazole 20 mg twice daily, amoxycillin 1000 mg twice daily, and clarithromycin 500 twice daily) for one week.</p><p><b>Results:</b> Median follow up was 44.6 (12–89) months. <i>H pylori</i> was successfully eradicated in 88 patients (98%); in two patients eradication therapy failed. Long term outcome was characterised by complete regression of lymphoma in 56 patients (62%), minimal residual disease in 17 patients (18%), partial remission in 11 patients (12%), no change in four patients (4%), and progressive disease in two patients (2%). Four patients with complete remission relapsed after 6, 8, 8, and 15 months, one revealing reinfection by <i>H pylori</i>. Regression rate was higher in stage I1 disease compared with stage I2, as diagnosed by endoscopic ultrasound.</p><p><b>Conclusion:</b> The majority of patients with low grade gastric MALT lymphoma treated by exclusive <i>H pylori</i> eradication have a favourable long term outcome, offering a real chance of cure.</p>" /> <meta name="citation_journal_title" content="Gut" /> <meta name="citation_publisher" content="BMJ Publishing Group" /> <meta name="citation_publication_date" content="2004/01/01" /> <meta name="citation_mjid" content="gutjnl;53/1/34" /> <meta name="citation_id" content="53/1/34" /> <meta name="citation_public_url" content="https://gut.bmj.com/content/53/1/34" /> <meta name="citation_abstract_html_url" content="https://gut.bmj.com/content/53/1/34.abstract" /> <meta name="citation_full_html_url" content="https://gut.bmj.com/content/53/1/34.full" /> <meta name="citation_pdf_url" content="https://gut.bmj.com/content/gutjnl/53/1/34.full.pdf" /> <meta name="citation_issn" content="0017-5749" /> <meta name="citation_issn" content="1468-3288" /> <meta name="citation_doi" content="10.1136/gut.53.1.34" /> <meta name="citation_pmid" content="14684573" /> <meta name="citation_volume" content="53" /> <meta name="citation_issue" content="1" /> <meta name="citation_article_type" content="Other" /> <meta name="citation_section" content="Stomach" /> <meta name="citation_firstpage" content="34" /> <meta name="citation_lastpage" content="37" /> <meta name="citation_author" content="W Fischbach" /> <meta name="citation_author" content="M-E Goebeler-Kolve" /> <meta name="citation_author" content="B Dragosics" /> <meta name="citation_author" content="A Greiner" /> <meta name="citation_author" content="M Stolte" /> <meta name="citation_reference" content="citation_title=Journal of Clinical Pathology;citation_journal_abbrev=J. 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Objective: To determine the long term outcome of patients undergoing exclusive H pylori eradication therapy. Design: A prospective series of patients with newly diagnosed marginal zone B cell lymphoma of MALT. Setting: Multicentre study in Germany and Austria. Patients: Ninety five patients; 90 of these (five lost to follow up) with a mean age of 54.3 (27–85) years were followed up for at least 12 months. Intervention: Complete staging work up revealing stage I disease and H pylori infection. Patients received triple therapy (OMC: omeprazole 20 mg twice daily, metronidazole 400 mg twice daily, and clarithromycin 250 mg twice daily; or OAC: omeprazole 20 mg twice daily, amoxycillin 1000 mg twice daily, and clarithromycin 500 twice daily) for one week. Results: Median follow up was 44.6 (12–89) months. H pylori was successfully eradicated in 88 patients (98%); in two patients eradication therapy failed. Long term outcome was characterised by complete regression of lymphoma in 56 patients (62%), minimal residual disease in 17 patients (18%), partial remission in 11 patients (12%), no change in four patients (4%), and progressive disease in two patients (2%). Four patients with complete remission relapsed after 6, 8, 8, and 15 months, one revealing reinfection by H pylori . Regression rate was higher in stage I1 disease compared with stage I2, as diagnosed by endoscopic ultrasound. Conclusion: The majority of patients with low grade gastric MALT lymphoma treated by exclusive H pylori eradication have a favourable long term outcome, offering a real chance of cure." /> <meta name="og-title" property="og:title" content="Long term outcome of patients with gastric marginal zone B cell lymphoma of mucosa associated lymphoid tissue (MALT) following exclusive Helicobacter pylori eradication therapy: experience from a large prospective series" /> <meta name="og-url" property="og:url" content="https://gut.bmj.com/content/53/1/34" /> <meta name="og-site-name" property="og:site_name" content="Gut" /> <meta name="og-description" property="og:description" content="Background: Helicobacter pylori plays a decisive role in the pathogenesis of gastric marginal zone B cell lymphoma of mucosa associated lymphoid tissue (MALT), and eradication therapy has become a widely accepted initial treatment of stage I disease. Objective: To determine the long term outcome of patients undergoing exclusive H pylori eradication therapy. Design: A prospective series of patients with newly diagnosed marginal zone B cell lymphoma of MALT. Setting: Multicentre study in Germany and Austria. Patients: Ninety five patients; 90 of these (five lost to follow up) with a mean age of 54.3 (27–85) years were followed up for at least 12 months. Intervention: Complete staging work up revealing stage I disease and H pylori infection. Patients received triple therapy (OMC: omeprazole 20 mg twice daily, metronidazole 400 mg twice daily, and clarithromycin 250 mg twice daily; or OAC: omeprazole 20 mg twice daily, amoxycillin 1000 mg twice daily, and clarithromycin 500 twice daily) for one week. Results: Median follow up was 44.6 (12–89) months. H pylori was successfully eradicated in 88 patients (98%); in two patients eradication therapy failed. Long term outcome was characterised by complete regression of lymphoma in 56 patients (62%), minimal residual disease in 17 patients (18%), partial remission in 11 patients (12%), no change in four patients (4%), and progressive disease in two patients (2%). Four patients with complete remission relapsed after 6, 8, 8, and 15 months, one revealing reinfection by H pylori . Regression rate was higher in stage I1 disease compared with stage I2, as diagnosed by endoscopic ultrasound. Conclusion: The majority of patients with low grade gastric MALT lymphoma treated by exclusive H pylori eradication have a favourable long term outcome, offering a real chance of cure." /> <meta name="og-type" property="og:type" content="article" /> <meta name="og-image" property="og:image" content="https://gut.bmj.com/sites/default/files/highwire/gutjnl/53/1.cover.gif" /> <link rel="alternate" type="application/vnd.ms-powerpoint" title="Powerpoint" href="/content/53/1/34.ppt" /> <title>Long term outcome of patients with gastric marginal zone B cell lymphoma of mucosa associated lymphoid tissue (MALT) following exclusive Helicobacter pylori eradication therapy: experience from a large prospective series | Gut</title> <link type="text/css" rel="stylesheet" href="/sites/default/files/advagg_css/css__cs4H-ozDNURO2fr2Idph3KIcn6aEoQkPKhyfPQ1osLY__0OcIZoC2x1Xie0etzHhyb5HTnp9UY9Cso4o9-0Cj54E__e4T8AzUp4yu1RtlH_tkD5ExVvOeVj35CuSiPLWPROtw.css" media="all" /> <!-- OneTrust Cookies Consent Notice 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term outcome of patients with gastric marginal zone B cell lymphoma of mucosa associated lymphoid tissue (MALT) following exclusive <em>Helicobacter pylori</em> eradication therapy: experience from a large prospective series</div></div> <span class="highwire-cite-access"><span class="highwire-citation-access highwire-citation-access-check" data-pisa-id="gutjnl;53/1/34" data-atom-uri="/gutjnl/53/1/34.atom" data-request-view="full"></span></span> </cite> </div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-highwire-panel-tabs-container col-narrow-12 clear" > <div class="pane-content"> <div data-panels-ajax-tab-preloaded="jnl_template_bmjj_tab_art" id="panels-ajax-tab-container-highwire_article_tabs" class="panels-ajax-tab-container"><div class="panels-ajax-tab-loading" style ="display:none"><img class="loading" src="https://gut.bmj.com/sites/all/modules/contrib/panels_ajax_tab/images/loading.gif" alt="Loading" title="Loading" /></div><div class="panels-ajax-tab-wrap-jnl_template_bmjj_tab_art"><div class="panel-display panel-1col clearfix" > <div class="panel-panel panel-col"> <div><div class="panel-pane pane-highwire-markup author-affiliates col-narrow-12 author-affiliates-corresp article" > <div class="pane-content"> <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" class="content-block-markup" xmlns:xhtml="http://www.w3.org/1999/xhtml"><div xmlns:xhtml="http://www.w3.org/1999/xhtml" class="contributors"><ol class="contributor-list" id="contrib-group-1"><li id="contrib-1"><span class="name">W Fischbach</span><a id="xref-aff-1-1" class="xref-aff" href="#aff-1">1</a>, </li><li id="contrib-2"><span class="name">M-E Goebeler-Kolve</span><a id="xref-aff-2-1" class="xref-aff" href="#aff-2">2</a>, </li><li id="contrib-3"><span class="name">B Dragosics</span><a id="xref-aff-3-1" class="xref-aff" href="#aff-3">3</a>, </li><li id="contrib-4"><span class="name">A Greiner</span><a id="xref-aff-5-1" class="xref-aff" href="#aff-5">5</a>, </li><li id="contrib-5"><span class="name">M Stolte</span><a id="xref-aff-4-1" class="xref-aff" href="#aff-4">4</a></li></ol><ol class="affiliation-list"><li class="aff"><a id="aff-1" name="aff-1"></a><address><sup>1</sup>Department of Internal Medicine, Klinikum Aschaffenburg, Aschaffenburg, Germany</address></li><li class="aff"><a id="aff-2" name="aff-2"></a><address><sup>2</sup>Medizinische Poliklinik, University of Würzburg, Würzburg, Germany</address></li><li class="aff"><a id="aff-3" name="aff-3"></a><address><sup>3</sup>Gesundheitszentrum Süd, Vienna, Austria</address></li><li class="aff"><a id="aff-4" name="aff-4"></a><address><sup>4</sup>Institute of Pathology, Klinikum Bayreuth, Bayreuth, Germany</address></li><li class="aff"><a id="aff-5" name="aff-5"></a><address><sup>5</sup>Institute of Pathology, University of Würzburg, Würzburg, Germany</address></li></ol><ol class="corresp-list"><li class="corresp" id="corresp-1"><span class="corresp-label"></span>Correspondence to:<br/> Professor W Fischbach<br/> Medizinische Klinik II, Klinikum Aschaffenburg, Am Hasenkopf, D-63739 Aschaffenburg, Germany; <span class="em-link" title="wolfgang.fischbach@klinikum-aschaffenburg.de"><span class="em-addr">wolfgang.fischbachklinikum-aschaffenburg.de</span></span></li></ol></div></div></div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-highwire-markup abstract-with-bc" > <div class="pane-content"> <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" id="content-block" xmlns:xhtml="http://www.w3.org/1999/xhtml"><div class="article abstract-view"><span class="highwire-journal-article-marker-start"></span><div class="section abstract" id="abstract-1"><h2>Abstract</h2> <p id="p-1"><strong>Background:</strong><em>Helicobacter pylori</em> plays a decisive role in the pathogenesis of gastric marginal zone B cell lymphoma of mucosa associated lymphoid tissue (MALT), and eradication therapy has become a widely accepted initial treatment of stage I disease.</p> <p id="p-2"><strong>Objective:</strong> To determine the long term outcome of patients undergoing exclusive <em>H pylori</em> eradication therapy.</p> <p id="p-3"><strong>Design:</strong> A prospective series of patients with newly diagnosed marginal zone B cell lymphoma of MALT.</p> <p id="p-4"><strong>Setting:</strong> Multicentre study in Germany and Austria.</p> <p id="p-5"><strong>Patients:</strong> Ninety five patients; 90 of these (five lost to follow up) with a mean age of 54.3 (27–85) years were followed up for at least 12 months.</p> <p id="p-6"><strong>Intervention:</strong> Complete staging work up revealing stage I disease and <em>H pylori</em> infection. Patients received triple therapy (OMC: omeprazole 20 mg twice daily, metronidazole 400 mg twice daily, and clarithromycin 250 mg twice daily; or OAC: omeprazole 20 mg twice daily, amoxycillin 1000 mg twice daily, and clarithromycin 500 twice daily) for one week.</p> <p id="p-7"><strong>Results:</strong> Median follow up was 44.6 (12–89) months. <em>H pylori</em> was successfully eradicated in 88 patients (98%); in two patients eradication therapy failed. Long term outcome was characterised by complete regression of lymphoma in 56 patients (62%), minimal residual disease in 17 patients (18%), partial remission in 11 patients (12%), no change in four patients (4%), and progressive disease in two patients (2%). Four patients with complete remission relapsed after 6, 8, 8, and 15 months, one revealing reinfection by <em>H pylori</em>. Regression rate was higher in stage I1 disease compared with stage I2, as diagnosed by endoscopic ultrasound.</p> <p id="p-8"><strong>Conclusion:</strong> The majority of patients with low grade gastric MALT lymphoma treated by exclusive <em>H pylori</em> eradication have a favourable long term outcome, offering a real chance of cure.</p> </div><ul class="kwd-group KWD"><li class="kwd">MALT lymphoma</li><li class="kwd">Helicobacter pylori</li><li class="kwd">eradication therapy</li></ul><ul class="kwd-group ABR"><li class="kwd">MALT, mucosa associated lymphoid tissue</li><li class="kwd">OMC, omeprazole, metronidazole, and clarithromycin</li><li class="kwd">OAC, omeprazole, amoxycillin, and clarithromycin</li><li class="kwd">EUS, endoscopic ultrasound</li></ul><span class="highwire-journal-article-marker-end"></span></div><span class="related-urls"></span></div></div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-dfp-pane oas-ads oas-ads-mid pull-right" > <div class="pane-content"> <div id="dfp-ad-mpu-wrapper" class="dfp-tag-wrapper"> <div id="dfp-ad-mpu" class="dfp-tag-wrapper"> <script type="text/javascript"> googletag.cmd.push(function() { googletag.display("dfp-ad-mpu"); }); </script> </div> </div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-custom pane-1" > <div class="pane-content"> <p><a href="https://doi.org/10.1136/gut.53.1.34" target="_new">https://doi.org/10.1136/gut.53.1.34</a></p> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-highwire-altmetrics" > <h2 class="pane-title">Statistics from Altmetric.com</h2> <div class="pane-content"> <div data-badge-details="right" data-badge-type="medium-donut" data-doi="10.1136/gut.53.1.34" data-hide-no-mentions="true" class="altmetric-embed"></div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-bmjj-jumplinks" > <div class="pane-content"> <div class="highwire-list-wrapper"><div class="highwire-list"><ul></ul></div></div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-custom pane-2 permissions-box" > <h2 class="pane-title">Request Permissions</h2> <div class="pane-content"> <p>If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. 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