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Characteristics and Treatment of Gastric MALT Lymphoma Unresponsive to Eradication Therapy―Special Reference to Multicenter Cooperative Trials Shigenori Kadowaki 1 , Toshihiko Doi 1 , Yoshimi Fujishima 1 , Atsushi Ohtsu 1 , Shigeaki Yoshida 2 1Division of Gastrointestinal Oncology/Digestive Endoscopy, National Cancer Center Hospital East, Kashiwa, Japan 2Director, National Cancer Center Hospital East, Kashiwa, Japan Keyword: 胃MALTリンパ腫 , H. pylori , 除菌治療 , 除菌無効例 pp.1261-1266
Published Date 2007/7/25
DOI https://doi.org/10.11477/mf.1403101158
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 Eradication of Helicobacter pylori (H. pylori) is considered a well accepted initial therapy in cases of localized low-grade gastric mucosa-associated lymphoid tissue (MALT) lymphoma. Cumulative data from several studies have shown that eradication of H. pylori induces complete remission in 50~95%of patients in localized low-grade gastric MALT lymphoma. Complete response is maintained for years in most patients, with about 10%relapse. H. pylori-negative MALT lymphoma, invasion beyond the submucosal layer, protrusion type, translocation t(11;18), or a component of high-grade lymphoma are the main factors that make lymphoma resistant to eradication. Second-line treatment for patients who failed to respond to eradication therapy, including radiotherapy and chemotherapy, resulted in a good response and good survival probability. Recently, there have been some data from multicenter trials about long-term follow-up after eradication therapy, but the evidence level in eradication therapy inclusive of second-line treatment for localized gastric MALT lymphoma is still low. The appropriate duration of observation before diagnosis of treatment failure, appropriate timing and methods of salvage therapy, and management of cases with high-grade components still remain to be defined. At present, multicenter trials, including some in Japan, are under way or are planned, and we look forward to the final results.


Copyright © 2007, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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