Helicobacter pylori eradication treatment for primary gastric diffuse large B-cell lymphoma: A single-center analysis

World J Clin Cases. 2023 Sep 26;11(27):6424-6430. doi: 10.12998/wjcc.v11.i27.6424.

Abstract

Background: Unlike the already established effect of Helicobacter pylori (H. pylori) eradication on gastric mucosa-associated lymphoid tissue (MALT) lymphoma, its therapeutic effect on primary gastric diffuse large B-cell lymphoma (DLBCL) is still unclear.

Aim: To clarify the efficacy of H. pylori eradication treatment for primary gastric DLBCL.

Methods: We reported on 3 new cases, and added them to 3 previously reported cases. We analyzed the usefulness of H. pylori eradication treatment for gastric DLBCL for a total of 6 cases at our center.

Results: Of the 6 patients (27-90 years old, 3 males and 3 females), all 3 patients with single lesions (one transformed from MALT lymphoma) achieved complete remission (CR) after H. pylori eradication. Regarding the 2 newly reported cases, CR was maintained for more than 6 years with eradication treatment alone. In contrast, none of the 3 patients with 2 lesions achieved CR. In 1 newly reported case, endoscopic CR was achieved in one lesion, while stable disease was obtained in the other lesion. Two patients with progressive disease responded to standard chemotherapy ± radiation and remained in CR for more than 6 years.

Conclusion: We believe it is worthwhile to attempt H. pylori eradication for elderly patients with primary gastric DLBCL in a single lesion with a small tumor burden.

Keywords: Eradication; Helicobacter pylori; Primary gastric diffuse large B-cell lymphoma; Treatment.