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Annals of Hematology

, Volume 94, Issue 6, pp 969–973 | Cite as

Antibiotic treatment as sole management of Helicobacter pylori-negative gastric MALT lymphoma: a single center experience with prolonged follow-up

  • Markus RadererEmail author
  • Stefan Wöhrer
  • Barbara Kiesewetter
  • Werner Dolak
  • Heimo Lagler
  • Andrew Wotherspoon
  • Leonhard Muellauer
  • Andreas Chott
Original Article

Abstract

Relatively little is known about the long-term outcome of patients with Helicobacter pylori (HP)-negative gastric lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) with antibiotic therapy as sole management. We have analyzed all patients with HP-negative gastric MALT lymphoma undergoing antibiotic therapy as sole management of their disease. HP negativity was defined as negative histology, breath test and serology, and response to treatment, survival and long-term outcome was assessed together with clinico-pathological characteristics including t(11; 18) (q21; q21) translocation. Out of 97 patients with gastric MALT lymphoma, 24 were HP-negative, and 13 (5 females and 8 males) underwent only antibiotic management for initial therapy. Eight had stage I and five were found to have stage II disease, with three patients suffering from an underlying autoimmune disease. Antibiotic therapy consisted of standard HP eradication regimens consisting of clarithromycin in all patients, along with metronidazole in seven and amoxicillin in six plus a proton-pump inhibitor. After a median follow-up of 95 months (42–, 181+), 12/13 patients are alive. Six patients with stage I disease achieved an objective response (five complete (CR) and one partial remission, 46 %), four had stable disease (lasting 11–27 months), and three progressed. All patients with stable disease received chemotherapy, but only one patient due to clear cut progression. One patient relapsed 23 months after initial CR, and achieved a second CR with antibiotics now lasting 87 months. These results indicate that a relevant percentage of patients with HP-negative gastric MALT lymphoma may benefit from antibiotic therapy and do not require additional oncological therapies. Our data suggest that the remissions seen in these patients might be durable as evidenced by prolonged follow-up in our series.

Keywords

MALT lymphoma Helicobacter pylori Antibiotics 

Notes

Conflict of interest

The authors disclose no potential conflict of interest for this manuscript. All authors have analyzed the data, helped in drafting and writing the manuscript and have approved of the final version of the paper.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Markus Raderer
    • 1
    • 7
    Email author
  • Stefan Wöhrer
    • 1
    • 6
  • Barbara Kiesewetter
    • 1
  • Werner Dolak
    • 2
  • Heimo Lagler
    • 1
  • Andrew Wotherspoon
    • 3
  • Leonhard Muellauer
    • 4
  • Andreas Chott
    • 5
  1. 1.Department of Internal Medicine IMedical University ViennaViennaAustria
  2. 2.Department of Internal Medicine IIIMedical University ViennaViennaAustria
  3. 3.Department of HistopathologyRoyal Marsden HospitalLondonUK
  4. 4.Departments of Internal Medicine and PathologyMedical University ViennaViennaAustria
  5. 5.Departments of Internal Medicine and PathologyWilheminenspitalViennaAustria
  6. 6.Krankenhaus Wiener NeustadtViennaAustria
  7. 7.Department of Internal Medicine I, Division of OncologyMedical UniversityViennaAustria

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