PREVENTION AND TREATMENT OF LOW-GRADE B-CELL PRIMARY GASTRIC LYMPHOMABY ANTI-H-PYLORI THERAPY

Mucosa-associated lymphoid tissue (MALT) showing a follicular structur e can develop in the gastric mucosa as a response to Helicobacter pylo ri infection. We emphasize the importance of anti-H. pylori antibiotic therapy in the elimination of acquired MALT. Of the 200 patients stud ied, acquired MALT was found in 70 of the 151 H. pylori-positive patie nts, whereas it was present in only five of the 49 H. pylori-negative patients. Thirty-eight H. pylori-positive and MALT-positive patients w ere treated with antibiotic therapy and reevaluated after 6 months: 21 patients were H. pylori negative/MALT negative, 12 were H. pylori pos itive/MALT positive, four were H. pylori negative/MALT positive, one w as H, pylori positive/MALT negative. In the control group (n = 20), H. pylori and acquired MALT were still present at follow-up. One patient with histological and immunohistochemical evidence of low-grade B-cel l gastric MALT lymphoma underwent antibiotic treatment and was reexami ned after 8, 12, and 24 weeks: histological examination of biopsy samp les showed regression of the MALT lymphoma in tandem with the disappea rance of H. pylori colonization. Our data confirm the correlation betw een H. pylori infection and acquired MALT, as documented by the abilit y of antibiotic therapy to induce the disappearance of acquired MALT a nd regression of MALT lymphoma. Considering the potential evolution of MALT into low-grade B-cell MALT lymphoma, H. pylori eradication shoul d play a role in the prevention of this tumor.