Efficacy of eradication therapy in Helicobacter pylori-negative gastric mucosa-associated lymphoid tissue lymphoma: A meta-analysis.

Abstract

BACKGROUND AND AIMS:

The role of eradication therapy in Helicobacter pylori-negative gastric mucosa-associated lymphoid tissue (MALT) lymphoma remains controversial. The aim of this study was to investigate the efficacy of H. pylori eradication therapy as a first-line treatment for H. pylori-negative gastric MALT lymphoma.

METHODS:

A literature search of studies published until October 2019 was performed using electronic databases. Studies that reported treatment response to eradication therapy as an initial treatment for patients with H. pylori-negative gastric MALT lymphoma were eligible for inclusion. The primary outcome was the complete remission rate after eradication therapy.

RESULTS:

Twenty-five studies were included in the analyses. The overall pooled complete remission rate was 29.3% (95% confidence interval [CI], 22.2%-37.4%, I2  = 41.5%). There was no publication bias, and the sensitivity analyses showed consistent results. The pooled complete remission rates were lower in the subgroups of studies that had a higher incidence of translocation t(11;18)(q21;q21) (19.9%, 95% CI, 11.6%-32.0%), studies that used serological tests to exclude H. pylori infection (27.5%, 95% CI, 20.1%-36.4%), and studies where non-response to eradication therapy was determined at <12 months after treatment (27.0%, 95% CI, 15.5%-42.7%). Meta-regression analysis revealed that the pooled estimate was not significantly different in terms of the characteristics of individual studies.

CONCLUSIONS:

Although the complete remission rate after eradication therapy is not high, it can be used as an initial treatment option in a subset of patients with H. pylori-negative gastric MALT lymphoma. Further studies to identify subgroups of patients who may benefit from eradication therapy are needed.

• Authors: Kyoungwon Jung, Do Hoon Kim, Hyun Il Seo, Eun Jeong Gong, Chang Seok Bang
• Journal: Helicobacter (Helicobacter) Vol. 26 Issue 2 Pg. e12774 (Apr 2021) ISSN: 1523-5378 [Electronic] England
• PMID: 33400830 (Publication Type: Journal Article, Meta-Analysis)
• Copyright: © 2021 John Wiley & Sons Ltd.

Chemical References

• Anti-Bacterial Agents

Topics

• Anti-Bacterial Agents (therapeutic use)
• Helicobacter Infections (drug therapy)
• Helicobacter pylori
• Humans
• Lymphoma, B-Cell, Marginal Zone
• Remission Induction
• Stomach Neoplasms (drug therapy)