Helicobacter pylori eradication therapy in gastric high grade Non Hodgkin's lymphoma (NHL)

Background: Primary gastric low-grade lymphoma of the mucosa associated lym phoid tissue (MALT) develops on the background of a chronic Helicobacter py lori (H. pylori) infection. Stable remissions can be induced by H. pylori e radication therapy as shown in clinical trials. In 8 cases of high-grade ga stric lymphomas remissions after H. pylori eradication were observed retros pectively. Aim: We started a pilot-trial to investigate the value of H. pylori eradica tion therapy in early gastric high-grade B-cell lymphoma prospectively. Patients and Methods: So far, two H. pylori positive patients with high-gra de B-cell lymphoma of the stomach stage Ann Arbor I E are included. They re ceived a triple eradication-therapy (Clarithromycin 500 mg/d, Metronidazol 800 mg/d and Omeprazol 40 mg/d) for 7 days. Endoscopic controls are preform ed every 4 weeks. Results: Both patients became H. pylori negative after eradication therapy. One patient achieved complete remission (CR) 38 days after eradication. Th e continuous complete remission lasts now for 170 days. The second patient received only a partial remission (PR) 4 weeks after eradication and showed a slight progress 4 weeks later. He presently receives chemotherapy (CHOP) . Conclusions: Patients with early high-grade gastric B-cell lymphomas should receive H. pylori eradication only within clinical trials. It seems to be possible to induce remissions of early high-grade gastric B-cell lymphomas with exclusive H. pylori eradication therapy. The stability of remission re mains to be unclear and should be evaluated by following up the patients cl osely.