Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Apr 7, 2015; 21(13): 3773-3776
Published online Apr 7, 2015. doi: 10.3748/wjg.v21.i13.3773
Helicobacter pylori eradication in gastric diffuse large B cell lymphoma
Semra Paydas
Semra Paydas, Department of Oncology, Cukurova University Faculty of Medicine 01330 Balcali, Turkey
Author contributions: This paper has been designed and written by Paydas S.
Conflict-of-interest: The author has no conflict of interest related to the manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Semra Paydas, MD, Professor, Department of Oncology, Cukurova University Faculty of Medicine, 01330 Balcali, Adana, Turkey. sepay@cu.edu.tr
Telephone: +90-322-3386060-3142 Fax: +90-322-3387320
Received: September 3, 2014
Peer-review started: September 3, 2014
First decision: October 29, 2014
Revised: November 18, 2014
Accepted: December 14, 2014
Article in press: December 16, 2014
Published online: April 7, 2015

Diffuse large B cell lymphoma (DLBCL) of the stomach is a heterogenous disease. There are tumors without histological evidence of mucosa-associated lymphoid tissue (MALT) lymphoma, which are classified as pure or de novo DLBCL and those with evidence of MALT, which are classified as DLBCL (MALT). The association between Helicobacter pylori (H. pylori) and gastric MALT lymphoma and remission with H. pylori eradication was shown in the 1990s. In recent years, scientists from Taiwan and others have shown that high-grade gastric lymphomas may be dependent on H. pylori and eradication of this microorganism is effective in these cases. This entity is biologically distinct from H. pylori (-) cases and has a better clinical outcome. There are sufficient data about the complete remission in some of these cases with brief treatment with antibiotics. With this strategy, it is possible to save some of these cases from the harmful effects of standard chemotherapy. It is time to treat these cases with H. pylori eradication. However, strict histopathological follow-up is crucial and histopathological response must be evaluated according to the scoring system proposed by Groupe d’Etude des Lymphomes de l’Adulte. If there is no sufficient response, chemotherapy must be given immediately. These results suggest that H. pylori dependency and high-grade transformation in gastric MALT lymphomas are distinct events.

Keywords: Helicobacter pylori, Eradication, Gastric diffuse large B cell lymphoma

Core tip: The association between Helicobacter pylori (H. pylori) and gastric mucosa-associated lymphoid tissue lymphoma has a long history and H. pylori eradication is the standard of care in these cases. In recent years, it has been shown that high-grade, early-stage gastric lymphoma may be dependent on H. pylori and eradication of this microorganism may be curative in some of the cases with gastric diffuse large B cell lymphoma. However, chemotherapy is a standard approach in cases unresponsive to H. pylori eradication.