Effect of Helicobacter pylori eradication therapy on the response of MALT-Gastric lymphoma

Tunis Med. 2022;100(1):37-43.

Abstract

Introduction: The link between gastric mucosa-associated lymphoid tissue lymphoma (LG-MALT) and chronic Helicobacter Pylori (HP) infection had led to a real revolution in the management of the disease.

Aims: To study the results of the HP eradication therapy and to clarify its place in the tumor response.

Methods: A descriptive retrospective bicentric study, between January 2007 and December 2016, including patients with LG-MALT treated in the gastroenterology departments of Sahloul hospital in Sousse and Habib Bougtafa hospital in Bizerte, and having received treatment for eradication of HP.

Results: Sixty-three patients were included. The male/female sex ratio was 1.42. The average age was 58 years. The symptomatology was dominated by epigastric pain (96.8%). On digestive endoscopy, the most frequent location and appearance were gastric antrum (39.6%) and ulcerations (89%). The lymphoma was classified as stage IE and IIE1 in 81% and 19% of cases, respectively. The HP status was positive in all patients. The HP eradication rate was 82.5% after three anti-HP treatment courses. Complete remission of lymphoma was obtained in 81% of patients at 18 months. Non-response to HP eradication therapy was observed in 19% of patients. Non-responder patients had a longer diagnostic delay (p=0.02), more diffuse endoscopic involvement (p=0.001) and a more frequent appearance of large gastric folds (p=0.001).

Conclusion: The course of LG-MALT is determined by the treatment for the eradication of HP. Its success promotes remission of lymphoma.

MeSH terms

  • Delayed Diagnosis
  • Female
  • Helicobacter Infections* / complications
  • Helicobacter Infections* / diagnosis
  • Helicobacter Infections* / drug therapy
  • Helicobacter pylori*
  • Humans
  • Lymphoma, B-Cell, Marginal Zone* / diagnosis
  • Lymphoma, B-Cell, Marginal Zone* / drug therapy
  • Lymphoma, B-Cell, Marginal Zone* / pathology
  • Lymphoma, Non-Hodgkin
  • Male
  • Middle Aged
  • Retrospective Studies
  • Stomach Neoplasms

Supplementary concepts

  • Familial primary gastric lymphoma