Complete remission of primary high-grade B-cell gastric lymphoma after cure of Helicobacter pylori infection

Purpose: Treatment of low-grade gastric mucosa-associated lymphoid tissue l ymphoma by eradication of Helicobacter pylori is reported to result in comp lete lymphoma remission in approximately 75% of cases. The effect that cure of the infection has on the course of a primary high-grade gastric lymphom a is largely uncertain. The aim of this study was to report the effect of c ure of H pylori infection exerted in patients with high-grade B-cell gastri c lymphoma. Patients and Methods: Eight patients (4 males and 4 females; age range, 26 to 85 years) with H pylori infection and high-grade lymphoma received eradi cation therapy before planned treatment. The effect of H pylori eradication on the course of high-grade lymphoma was assessed by analysis of surgical specimens (n = 2) or endoscopic biopsies (n = 6). Results: H pylori eradication was successful in all patients and led to com plete remission of the lymphoma in seven patients. One patient has experien ced partial remission. Two patients were referred to surgery, one of whom ( stage II1E) had lymph node involvement, and the histologic work-vp of the r esected stomach revealed residual infiltrates of a low-grade lymphoma, whic h prompted consolidation chemotherapy, In one patient (initially stage I-1E ), abdominal lymphoma developed 6 months after eradication therapy, which r egressed completely after chemotherapy, In four patients, no further treatm ent was given, Six patients continue in complete remission (range, 6 to 66 months). Conclusion: Primary high-grade B-cell gastric lymphoma in stages I-E throug h IIE1 associated with H pylori may regress completely after successful cur e of the infection. Prospective trials are needed to investigate this treat ment in larger numbers of patients. (C) 2001 by American Society of Clinica l Oncology.