Prospective long-term endoscopic and histologic follow-up of gastric lymphoproliferative disease of early Stage I-E low-grade B-cell mucosa-associated lymphoid tissue type following Helicobacter pylori eradication treatment

Long-term endoscopic and histologic follow-up of Stage I-E gastric lymphopr oliferative disease of the low-grade B-cell mucosa-associated lymphoid tiss ue (MALT) type following cure of H. pylori was undertaken. Clinical and end oscopic features (age, race, endoscopic appearance, cure of H. pylori and d uration of follow-up) were also evaluated as potential prognostic indicator s for complete or near-complete regression of low-grade MALT lymphoma. Sixt y-eight MALT lymphoma patients prospectively underwent H. pylori eradicatio n. Follow-up at periodic intervals with endoscopy and extensive mucosal bio psy protocol on 65 patients ranging from 12 weeks up to 73 months (mean +/- SD of 22.5 +/- 15.8 months) has been completed. H, pylori was eradicated i n 89.2% of MALT lymphoma patients with complete histologic regression noted in 58.5%, near-complete regression in 18.5%, partial in 4.6%, and no chang e in 18.5%. Univariate analysis revealed two factors predictive of complete and/or near complete MALT lymphoma regression, H. pylori cure (p=0.001) an d duration of follow-up (p=0.001). Stepwise logistic regression also demons trated that both H. pylori cure (p<0.0001) and duration of follow-up (p<0.0 2) were independently associated with complete and near complete MALT lymph oma regression. Age, race, and endoscopic appearance were not predictive of regression. We conclude that this lymphoproliferative disease predictably undergoes complete to near-complete histologic regression at variable rates following cure of H. pylori in a majority of patients.