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Long-term follow-up of gastric malt lymphoma after H. pylori eradication

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Abstract

For almost 10 years, we have been familiar with the concept of mucosa-associated lymphoid tissue (MALT)-type lymphoma of the stomach caused by chronic Helicobacter pylori infection. Many epidemiologic, biologic, and molecular genetic studies have implicated H. pylori for its role in lymphoma genesis. Since the first reports on complete remission of gastric MALT lymphomas after cure of bacterial infection, many clinical studies have investigated the effect of eradicating H. pylori on the course of MALT lymphoma, and indeed were able to confirm remission of the lymphoma. To date, more than 650 patients worldwide have been treated for gastric MALT lymphoma with antibiotics, and we have gained many new insights concerning the biologic behavior of this disease, especially from the deepened knowledge of cytogenetics. Furthermore, factors relevant for the prediction of treatment outcome have been identified, which has helped to stratify patients into risk groups.

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References and Recommended Reading

  1. Wyatt JI, Rathbone BJ: Immune response of the gastric mucosa to Campylobacter pylori. Scand J Gastroenterol 1988, 23:44–49.

    Google Scholar 

  2. Parsonnet J, Hansen S, Rodriguez L, et al.: Helicobacter pylori infection and gastric lymphoma. N Engl J Med 1994, 330:1267–1271.

    Article  PubMed  CAS  Google Scholar 

  3. Hussell T, Isaacson PG, Crabtree JE, Spencer J: The response of cells from low-grade B-cell gastric lymphomas of mucosa-associated lymphoid tissue to Helicobacter pylori. Lancet 1993, 342:571–574.

    Article  PubMed  CAS  Google Scholar 

  4. Hussell T, Isaacson PG, Crabtree JE, Spencer J: Helicobacterpylori specific tumour infiltrating T-cells provide contact dependant help for the growth of malignant B-cells in low-grade gastric lymphoma of mucosa-associated lymphoid tissue. J Pathol 1996, 178:122–127.

    Article  PubMed  CAS  Google Scholar 

  5. Dierlamm J, Wlodarska I, Michaux L, et al.: Genetic abnormalities in marginal zone B-cell lymphoma. Hematol Oncol 2000, 18:1–13. An excellent review on genetic abnormalities that provides up-to-date information on all relevant genetic mechanisms.

    Article  PubMed  CAS  Google Scholar 

  6. Wotherspoon AC, Doglioni C, Diss TC, et al.: Regression of primary low-grade B-cell gastric lymphoma of mucosaassociated lymphoid tissue type after eradication of Helicobacter pylori. Lancet 1993, 342:575–577.

    Article  PubMed  CAS  Google Scholar 

  7. Bayerdörffer E, Neubauer, A, Rudolph B, et al.: Regression of primary gastric lymphoma of mucosa-associated lymphoid tissue after cure of Helicobacter pylori infection. Lancet 1995, 345:1591–1594.

    Article  PubMed  Google Scholar 

  8. Neubauer A, Thiede C, Morgner A, et al.: Cure of Helicobacter pylori infection and duration of remission of low-grade gastric mucosa-associated lymphoid tissue lymphoma. J Natl Cancer Inst 1997, 89:1350–1355.

    Article  PubMed  CAS  Google Scholar 

  9. Roggero E, Zucca E, Pinotti G, et al.: Eradication of Helicobacter pylori infection in primary low-grade gastric lymphoma of mucosa-associated lymphoid tissue. Ann Int Med 1995, 122:767–769.

    PubMed  CAS  Google Scholar 

  10. Stolte M, Morgner A, Alpen B, et al.: Evaluation of the longterm outcome of Helicobacter pylori-related gastric mucosa-associated lymphoid tissue (MALT) lymphoma. In Helicobacter pylori — Basic Mechanisms to Clinical Cure 2000. Edited by Hunt RH, Tytgat GNJ. Dordrecht: Kluver Academic Publishers; 2000:541–548.

    Google Scholar 

  11. Fischbach W, Dragosics B, Kolve-Göbeler ME, et al.: Primary gastric B-cell lymphoma: results of a prospective multicenter study. Gastroenterology 2000, 119:1191–1202.

    Article  PubMed  CAS  Google Scholar 

  12. Savio A, Zamboni G, Capelli P, et al.: Relapse of low-grade gastric MALT lymphoma after Helicobacter pylori eradication: true relapse or persistence? Long-term post-treatment follow-up of a multicenter trial in the north-east of Italy and evaluation of the diagnostic protocol’s adequacy. Recent Results Cancer Res 2000, 156:116–124.

    PubMed  CAS  Google Scholar 

  13. Ruskoné-Formestraux A, Lavergne A, Aegerter PH, et al.: Predictive factors for regression of gastric MALT lymphoma after anti-Helicobacter pylori treatment. Gut 2001, 48:29–303. This paper describes the most relevant predictive factors for lymphoma remission. Patients can be stratified into risk groups according to these factors.

    Article  Google Scholar 

  14. Steinbach G, Ford R, Glober G, et al.: Antibiotic treatment of gastric lymphoma of mucosa-associated lymphoid tissue: an uncontrolled trial. Ann Intern Med 1999, 131:88–95.

    PubMed  CAS  Google Scholar 

  15. Thiede C, Wündisch T, Neubauer B, et al.: Eradication of Helicobacter pylori and stability of remissions in low-grade gastric B-cell lymphomas of the mucosa-associated lymphoid tissue: results of an ongoing multicenter trial. Recent Results Cancer Res 2000, 156:125–133.

    PubMed  CAS  Google Scholar 

  16. Montalban C, Santon A, Boixeda D, et al.: Treatment of low-grade gastric mucosa-associated lymphoid tissue lymphoma in stage I with Helicobacter pylori eradication: long-term results after sequential histologic and molecular follow-up. Haematologica 2001, 86:609–617.

    PubMed  CAS  Google Scholar 

  17. Oda I: Endoscopic evaluation of Helicobacter pylori eradication. Stomach Intest 1999, 34:1381–1388.

    Google Scholar 

  18. Kato T: Regression of gastric low-grade MALT lymphoma after eradication of Helicobacter pylori. Stomach Intest 1999, 34:1345–1352.

    Google Scholar 

  19. Suekane H: Clinical course and practical guideline after eradication of Helicobacter pylori: the value of clinical typing based on endosonographic findings. Stomach Intest 1999, 34:1397–1409.

    Google Scholar 

  20. Suzuki T: Clinicopathological features of MALT lymphoma. Stomach Intest 1999, 34:1367–1379.

    Google Scholar 

  21. Nakamura S, Matsumoto T, Suekane H, et al.: Predicative value of endoscopic ultrasonography for the regression of gastric low-grade and high-grade MALT lymphomas after eradication of Helicobacter pylori. Gut 2001, 48:545–460.

    Article  Google Scholar 

  22. Yamashita H, Watanabe H, Ajioka Y, et al.: When can complete regression of low-grade gastric lymphoma of mucosaassociated lymphoid tissue be predicted after Helicobacter pylori eradication? Histopathology 2000, 37:131–140.

    Article  PubMed  CAS  Google Scholar 

  23. Isaacson PG, Spencer J: Malignant lymphoma of mucosaassociated lymphoid tissue. Histopathology 1987, 11:44–49.

    Article  Google Scholar 

  24. de Jong D, Boot J, Van Heerde P, et al.: Histological grading in gastric lymphoma: pretreatment criteria and clinical relevance. Gastroenterology 1997, 112:1466–1474.

    Article  PubMed  Google Scholar 

  25. Boot H, de Jong D, van Heerde P, Taal BG: Role of Helicobacter pylori eradication in high grade MALT lymphoma. Lancet 1995, 346:448–449.

    Article  PubMed  CAS  Google Scholar 

  26. Roggero E, Copie-Bergmann C, Traullé C, et al.: Regression of high-grade B-cell gastric lymphoma after eradication of Helicobacter pylori infection [abstract]. Proc ASCO 1999, 18:A230.

    Google Scholar 

  27. Ng WW, Lam CP, Chau WK, et al.: Regression of high-grade gastric mucosa-associated lymphoid tissue lymphoma with Helicobacter pylori after triple antibiotic therapy. Gastrointest Endosc 2000, 51:93–96.

    Article  PubMed  CAS  Google Scholar 

  28. Morgner A, Miehlke S, Fischbach et al.: Complete remission of primary high-grade B-cell gastric lymphoma after cure of Helicobacter pylori infection. J Clin Oncol 2001, 19:2041–2048. Report on eight patients with high-grade gastric lymphoma and complete remission after cure of the infection.

    PubMed  CAS  Google Scholar 

  29. Hiyama T, Haruma K, Kitadai Y, et al.: Helicobacter pylori eradication therapy for high-grade mucosa-associated lymphoid tissue lymphomas of the stomach with analysis of p53 and K-ras alteration and microsatellite instability. Int J Oncol 2001, 18:1207–1212.

    PubMed  CAS  Google Scholar 

  30. Miki H, Kobajashi S, Harada H, et al.: Early stage MALT lymphoma with high-grade component cured by Helicobacter pylori eradication. J Gastroenterol 2001, 36:121–124.

    Article  PubMed  CAS  Google Scholar 

  31. Sackmann M, Morgner A, Rudolph B, et al.: Regression of MALT lymphoma following eradication of Helicobacter pylori is predicted by endosonographic staging. Gastroenterology 1997, 113:1087–1090.

    Article  PubMed  CAS  Google Scholar 

  32. de JongD, Vyth-Dreese F, Dellemijn T, et al.: Histological and immunological parameters to predict treatment outcome of Helicobacter pylori eradication in low-grade gastric MALT lymphoma. J Pathol 2001, 193:318–324.

    Article  PubMed  Google Scholar 

  33. Weston AP, Banerjee SK, Horvat RT, et al.: Specificity of polymerase chain reaction monoclonality for diagnosis of gastric mucosa-associated lymphoid tissue (MALT) lymphoma. Dig Dis Sci 1998, 43:290–299.

    Article  PubMed  CAS  Google Scholar 

  34. Diss TC, Peng H, Wotherspoon AC, et al.: Detection of monoclonality in low-grade B-cell lymphomas using the polymerase chain reaction is dependent on primer selection and lymphoma type. J Pathol 1993, 169:291–295.

    Article  PubMed  CAS  Google Scholar 

  35. Thiede C, Wündisch T, Alpen B, et al.: Long-term persistence of monoclonal B-cells after cure of Helicobacter pylori infection and complete histologic remission in gastric mucosa-associated lymphoid tissue B-cell lymphoma. J Clin Oncol 2001, 19:1600–1609. Ninety-seven well-documented patients in complete lymphoma remission were analyzed according to their molecular follow-up. The authors define the term "molecular remission.".

    PubMed  CAS  Google Scholar 

  36. Gruhn B, Hongeng S, Yi H, et al.: Minimal residual disease after intensive induction therapy in childhood acute lymphoblastic leukemia predicts outcome. Leukemia 1998, 12:675–681.

    Article  PubMed  CAS  Google Scholar 

  37. Zwicky CS, Maddocks AB, Andersen N, Gribben JG: Eradication of polymerase chain reaction detectable immunoglobulin gene rearrangement in non-Hodgkin’s lymphoma is associated with decreased relapse after autologous bone marrow transplantation. Blood 1996, 88:3314–3322.

    PubMed  CAS  Google Scholar 

  38. Auer IA, Gascoyne RD, Connors JM, et al.: t(11;18)(q21;q21) is the most common translocation in MALT lymphomas. Ann Oncol 1997, 8:979–985.

    Article  PubMed  CAS  Google Scholar 

  39. Ott G, Katzenberger T, Greiner A, et al.: The t(11;18)(q21;q21) chromosome translocation is a frequent and specific aberration in low-grade but not high-grade malignant non-Hodgkin’s lymphomas of the mucosa-associated lymphoid tissue (MALT) type. Cancer Res 1997, 57:3944–3947. This is the first report on the translocation t(11;18) and its relationship to MALT lymphoma.

    PubMed  CAS  Google Scholar 

  40. Dierlamm J, Baens M, Wlodarska I, et al.: The apoptosis inhibitor gene API2 and a novel 18q gene, MLT, are recurrently rearranged in the t(11;18)(q21;q21) associated with MALT lymphomas. Blood 1999, 93:3601–3609.

    PubMed  CAS  Google Scholar 

  41. Agaki T, Tamura A, Motegi M, et al.: Molecular cytogenetic delineation of the breakpoint at 18q21.1 in low-grade B-cell lymphoma of mucosa-associated lymphoid tissue. Genes Chromosom Cancer 1999, 24:315–321.

    Article  Google Scholar 

  42. Stoffel A, Rao PH, Louie DC, et al.: Chromosome 18 breakpoint in t(11;18)(q21;q21) translocation associated with MALT lymphoma is proximal to BCL2 and distal to DCC. Chromosom Cancer 1999, 24:156–159.

    Article  CAS  Google Scholar 

  43. Alpen B, Neubauer A, Dierlamm J, et al.: Translocation t(11;18) absent in early gastric marginal zone B-cell lymphoma of MALT type responding to eradication therapy of Helicobacter pylori infection. Blood 2000, 95:4014–4015.

    PubMed  CAS  Google Scholar 

  44. Liu H, Ruskoné-Formestraux A, Lavergne-Slove A, et al.: resistance of t(11;18) positive gastric mucosa-associated lymphoid tissue lymphoma to Helicobacter pylori eradication therapy. Lancet 2001, 357:39–40. This report documents genetic abnormality as a marker for nonresponsive gastric MALT lymphomas. Seventy-five percent of the patients who failed eradication therapy harbored the translocation.

    Article  PubMed  CAS  Google Scholar 

  45. Willis TG, Jadayel DM, Du MQ, et al.: BCL10 is involved in t(1;14)(p22;q32) of MALT B cell lymphoma and mutated in multiple tumor types. Cell 1999, 96:35–45.

    Article  PubMed  CAS  Google Scholar 

  46. Zhang Q, Siebert R, Yan M, et al.: Inactivating mutations and overexpression of BCL10, a caspase recruitment domaincontaining gene, in MALT lymphoma with t(1;14)(p22;q32). Nat Genet 1999, 22:63–68.

    Article  PubMed  CAS  Google Scholar 

  47. Du MQ, Peng HZ, Liu H, et al.: BCL10 mution in lymphoma. Blood 2000, 95:3885–3890.

    PubMed  CAS  Google Scholar 

  48. Lucas PC, Yonezumi M, Inohara N, et al.: Bcl10 and MALT1, independent targets of chromosomal translocation in MALT lymphoma, cooperate in a novel NF-kappa B signaling pathway. J Biol Chem 2001, 276:19012–19019. The authors offer deep insight into the pathogenetic mechanisms, suggesting a synergistic antiapoptotic function of BCL10 and the fusion protein of t(11;18)(q21;q21).

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Institute for Pathology, Klinikum Bayreuth, Preuschwitzer Str. 101, 95455, Bayreuth, Germany

    Andrea Morgner MD, Christian Thiede MD, Ekkehard Bayerdörffer MD, PhD, Birgit Alpen MD, Thomas Wündisch MD, Andreas Neubauer MD, PhD & Manfred Stolte MD, PhD

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  1. Andrea Morgner MD
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  2. Christian Thiede MD
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  3. Ekkehard Bayerdörffer MD, PhD
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  4. Birgit Alpen MD
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  5. Thomas Wündisch MD
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  6. Andreas Neubauer MD, PhD
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  7. Manfred Stolte MD, PhD
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Morgner, A., Thiede, C., Bayerdörffer, E. et al. Long-term follow-up of gastric malt lymphoma after H. pylori eradication. Curr Gastroenterol Rep 3, 516–522 (2001). https://doi.org/10.1007/s11894-001-0073-9

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  • DOI: https://doi.org/10.1007/s11894-001-0073-9

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