Management and long-term follow-up of early stage H. pylori-associated gastric MALT-lymphoma in clinical practice: An Italian, multicentre study

Background/Aim. Data on management and long-term follow-up of Helicobacter pylori-associated MALT-lymphoma in clinical practice are scanty. We evaluate the long-term efficacy of H. pylori eradication on low-gurade MALT-lymphoma, and the efficacy of further therapies in refractory patients. Methods. This study enrolled patients with stages I-II(1) MALT-lymphoma and H. pylori infection. H. pylori eradication was attempted in all patients. Patients with lymphoma persistence or progression following H. pylori treatments received further lymphoma treatments. Both 5-year and disease-free survivals were calculated. Results. Sixty patients (stage I/II(1): 50/10) were followed Lip for a median time of 65 months (range 7-156). H. pylori infection was successfully eradicated in 53 (88.3%) patients following three consecutive therapeutic attempts, and lymphoma regressed in 42 (79.2%) of these patients. Sixteen patients received anti-neoplastic treatments due to either lymphoma persistence or progression, and lymphoma was cured in 14 (87.5%) cases. At follow-Lip, lymphoma relapsed in 13/42 (30.9%) patients within a median time of 19 months (range 3-41), and all but 1 patient were cured with further therapies. Overall, lymphoma regression was achieved in 56 patients (93.3%). The 5-year and disease-free survivals were 94.7% and 74.6%, respectively. Conclusions. In clinical practice, a conservative approach with antibiotic eradication seems to be appropriate management for eady-stage MALT-lymphoma, with oncologic therapy being reserved for those patients who fail to respond to H. pylori therapy, (C) 2008 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.