CURE OF HELICOBACTER-PYLORI INFECTION AND DURATION OF REMISSION OF LOW-GRADE GASTRIC MUCOSA-ASSOCIATED LYMPHOID-TISSUE LYMPHOMA

Background: Low-grade B-cell lymphomas arising in mucosa-associated ly mphoid tissue (MALT) are most frequently localized in the gastrointest inal tract, More than 90% of gastric MALT lymphomas are diagnosed in p atients with chronic, Helicobacter pylori-associated gastritis, High r emission rates for these lymphomas have been observed after the cure o f H. pylori infection, Data are lacking, however, with regard to the d uration of the remissions, To address this question of remission durat ion, we have followed 50 patients in whom H. pylori infections were er adicated, and we determined whether the patients in complete remission displayed evidence of residual monoclonal B cells during follow-up, M ethods: Patients were treated with amoxycillin and omeprazole for 2 we eks in an attempt to cure H. pylori infections, Follow-up included end oscopic investigations with biopsy sampling, Monoclonal B cells in bio psy specimens were detected by means of a polymerase chain reaction (P CR)-based assay, Results: H. pylori infections were cured in all 50 pa tients, The median follow-up for the 50 patients is currently 24 month s (729 days; range, 135-1411 days), Forty patients achieved complete r emission of their lymphomas, but five have subsequently relapsed, The median time of continuous complete remission for the 40 patients was 1 5.4 months (468 days; range, 0-1198 days), Among six patients whose ly mphomas did not respond to H. pylori eradication, four revealed high-g rade lymphomas upon surgery, PCR indicated the presence of monoclonal B cells during follow-up in 22 of 31 assessable patients in complete r emission, Conclusions: Complete remissions of low-grade gastric MALT l ymphomas after the cure of H. pylori infection appear to be stable, al though most patients display evidence of monoclonal B cells during fol low-up, Whether these patients are truly cured of their lymphomas rema ins to he determined.