Long-term follow-up of gastric MALT lymphoma after Helicobacter pylori eradication
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Long-term follow-up of gastric MALT lymphoma after Helicobacter pylori eradication. / Wündisch, Thomas; Thiede, Christian; Morgner, Andrea; Dempfle, Astrid; Günther, Annette; Liu, Hongxiang; Ye, Hongtao; Du, Ming-Qing; Kim, Theo D; Bayerdörffer, Ekkehard; Stolte, Manfred; Neubauer, Andreas.
in: J CLIN ONCOL, Jahrgang 23, Nr. 31, 01.11.2005, S. 8018-24.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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T1 - Long-term follow-up of gastric MALT lymphoma after Helicobacter pylori eradication
AU - Wündisch, Thomas
AU - Thiede, Christian
AU - Morgner, Andrea
AU - Dempfle, Astrid
AU - Günther, Annette
AU - Liu, Hongxiang
AU - Ye, Hongtao
AU - Du, Ming-Qing
AU - Kim, Theo D
AU - Bayerdörffer, Ekkehard
AU - Stolte, Manfred
AU - Neubauer, Andreas
PY - 2005/11/1
Y1 - 2005/11/1
N2 - PURPOSE: Cure of infection induces remissions in most patients with early stage Helicobacter pylori- (Hp) positive gastric MALT (mucosa-associated lymphoid tissue) lymphoma (GML). We tracked the long-term stability of remissions in this prospective, multicenter trial.PATIENTS AND METHODS: In 120 patients with stage I(1E) disease, we performed sequential endoscopic-bioptic follow-up after Hp eradication and polymerase chain reaction of the rearranged immunoglobulin heavy chain gene. The status of t(11;18) was assessed in 65 patients.RESULTS: Median follow-up was 75 months (range, one to 116). Five-year survival was 90%. Eighty percent of patients (96 of 120) achieved complete histologic remission (CR). Eighty percent of CRs are in continuous complete histologic remission (CCR). Three percent of CR patients (three of 96) relapsed and were referred for alternative treatment. Seventeen percent of CR patients (16 of 96) showed histologic residual disease (RD) during follow-up; a watch-and-wait strategy was applied, and all entered into a second CR. After a median follow-up of 63 months, 14 of 52 analyzed patients reaching CR showed ongoing B-cell monoclonality. Fifteen percent of GMLs were t(11;18) positive. Both t(11;18) and ongoing monoclonality were associated with a significantly higher risk for no response or relapse (P =.004, P =.007), but also present in patients in CCR. Early gastric cancer was diagnosed in three cases during follow-up.CONCLUSION: Cure of Hp infection results in CCR in most patients. Histologic RD, B-cell monoclonality, and t(11;18) were present in a considerable number of CR patients. A watch-and-wait strategy is justified when close follow-up is guaranteed.
AB - PURPOSE: Cure of infection induces remissions in most patients with early stage Helicobacter pylori- (Hp) positive gastric MALT (mucosa-associated lymphoid tissue) lymphoma (GML). We tracked the long-term stability of remissions in this prospective, multicenter trial.PATIENTS AND METHODS: In 120 patients with stage I(1E) disease, we performed sequential endoscopic-bioptic follow-up after Hp eradication and polymerase chain reaction of the rearranged immunoglobulin heavy chain gene. The status of t(11;18) was assessed in 65 patients.RESULTS: Median follow-up was 75 months (range, one to 116). Five-year survival was 90%. Eighty percent of patients (96 of 120) achieved complete histologic remission (CR). Eighty percent of CRs are in continuous complete histologic remission (CCR). Three percent of CR patients (three of 96) relapsed and were referred for alternative treatment. Seventeen percent of CR patients (16 of 96) showed histologic residual disease (RD) during follow-up; a watch-and-wait strategy was applied, and all entered into a second CR. After a median follow-up of 63 months, 14 of 52 analyzed patients reaching CR showed ongoing B-cell monoclonality. Fifteen percent of GMLs were t(11;18) positive. Both t(11;18) and ongoing monoclonality were associated with a significantly higher risk for no response or relapse (P =.004, P =.007), but also present in patients in CCR. Early gastric cancer was diagnosed in three cases during follow-up.CONCLUSION: Cure of Hp infection results in CCR in most patients. Histologic RD, B-cell monoclonality, and t(11;18) were present in a considerable number of CR patients. A watch-and-wait strategy is justified when close follow-up is guaranteed.
KW - Adult
KW - Aged
KW - Aged, 80 and over
KW - Anti-Bacterial Agents
KW - Chromosomes, Human, Pair 11
KW - Chromosomes, Human, Pair 18
KW - Drug Therapy, Combination
KW - Female
KW - Follow-Up Studies
KW - Gene Rearrangement
KW - Helicobacter Infections
KW - Helicobacter pylori
KW - Humans
KW - Immunoglobulin Heavy Chains
KW - Lymphoma, B-Cell, Marginal Zone
KW - Male
KW - Middle Aged
KW - Neoplasm Staging
KW - Prognosis
KW - Prospective Studies
KW - Remission Induction
KW - Stomach Neoplasms
KW - Survival Rate
KW - Time Factors
KW - Translocation, Genetic
KW - Journal Article
KW - Multicenter Study
KW - Research Support, Non-U.S. Gov't
U2 - 10.1200/JCO.2005.02.3903
DO - 10.1200/JCO.2005.02.3903
M3 - SCORING: Journal article
C2 - 16204012
VL - 23
SP - 8018
EP - 8024
JO - J CLIN ONCOL
JF - J CLIN ONCOL
SN - 0732-183X
IS - 31
ER -