The role of antibiotics in early stage gastric mucosa associated lymphoid tissue lymphoma negative for Helicobacter pylori has not been investigated.
Dr Raderer and colleagues from Austria localized 6 patients with gastric mucosa associated lymphoid tissue lymphoma.
The patients underwent antibiotic treatment with clarithromycin, metronidazole, and pantoprazole.
The investigative team performed multiple tests to rule out distant spread of the disease.
|5 patients responded with lymphoma regression following antibiotic treatment|
Staging, including endosonography plus gastroscopy, computed tomography of the thorax and abdomen, and colonoscopy were performed.
The team also used magnetic resonance imaging of the salivary glands, and bone marrow biopsies.
In addition, mucosa associated lymphoid tissue specific genetic changes, including reverse transcriptase-polymerase chain reaction for t(11;18)(q21;q21) were tested in all patients.
H pylori infection was ruled out by histology, urease breath test, serology, and stool antigen testing.
The investigators found that all 6 patients had mucosa associated lymphoid tissue lymphoma restricted to the stomach.
None of the patients had evidence of infection with H pylori.
Only 1 patient tested positive for t(11;18)(q21;q21), while the remaining 5 displayed no genetic aberrations.
Following antibiotic treatment, the team performed endoscopic controls were every 3 months.
The investigators observed that 5 patients responded with lymphoma regression between 3 and 9 months following antibiotic treatment.
Of these 5 patients, 1 experienced partial remission and 4 had complete responses.
The team reported that 1 patient had stable disease for 12 months, and was then referred for chemotherapy.
Dr Raderer's team concluded, “Patients with early stage gastric mucosa associated lymphoid tissue lymphoma negative for H pylori might still benefit from antibiotic treatment as the sole treatment modality.”