ERADICATION OF HELICOBACTER-PYLORI INFECTION IN PRIMARY LOW-GRADE GASTRIC LYMPHOMA OF MUCOSA-ASSOCIATED LYMPHOID-TISSUE

Objective: To determine the effect of eradicating Helicobacter pylori infection on the course of low-grade gastric mucosa-associated lymphoi d tissue (MALT) lymphoma. Design: Prospective cohort study. Setting: U niversity internal medicine clinics, a referral oncology center in sou thern Switzerland, and a gastroenterology referral center in northern Italy.Patients: 26 patients with localized primary low-grade gastric M ALT lymphoma. Intervention: Treatment for H. pylori infection (bismuth or omeprazole or both, amoxicillin, and metronidazole for 14 days). M ain Outcome Measures: Endoscopic biopsy specimens of the gastric mucos a were obtained every 3 to 6 months after treatment for H. pylori infe ction. Results: Helicobacter pylori was completely eradicated in 25 of 26 patients, but 4 patients needed second-line antibiotic treatment t o eradicate the microorganism. Disappearance or almost total regressio n of the lymphomatous tissue was observed in 15 of the 25 evaluable pa tients (60%; CI, 39% to 79%); however, disappearance or almost total r egression was evident in the first biopsy specimen after treatment for H. pylori infection in only 8 of the 15 patients. Conclusions: Our st udy confirms recent anecdotal reports of regression of gastric MALT ly mphoma after eradication of H. pylori and indicates that the growth of these extranodal lymphomas may depend on H. pylori.