Digestive Diseases and Sciences

, Volume 51, Issue 4, pp 775–778 | Cite as

Successful Treatment of Helicobacter Pylori-Negative Gastric MALT Lymphoma With Rituximab

  • Nadeem Chaudhary
  • Howard Ozer
  • David Huard
  • Stan Lightfoot
  • Sikandar Mesiya
Esophageal, Gastric, and Duodenal Disorders


Helicobacter pylori infection is strongly associated with low-grade gastric lymphoma, commonly known as mucosa-associated lymphoid tissue (MALT) lymphoma. H. pylori eradication leads to complete remission in 80% of early stage MALT lymphomas. The treatment for early stage H. pylori-negative gastric MALT lymphoma is evolving. Rituximab, a chimeric anti-CD20 antibody, has shown response rates of approximately 50% with minimal toxicity in patients with B-cell non-Hodgkin lymphoma. We describe herein the clinical, endoscopic, and histologic features of a patient with H. pylori-negative gastric MALT lymphoma treated successfully with rituximab.

Key Words

gastric mucosal associated lymphoid tissue (MALT) lymphoma Helicobacter pylori (H. pylorirituximab 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Lewin KJ, Ranchod M, Dorfman RF, et al.: Lymphomas of the gastrointestinal tract: A study of 117 cases presenting with gastrointestinal disease. Cancer 42:693–707, 1978PubMedGoogle Scholar
  2. 2.
    Ahmad A, Govil Y, Frank BB: Gastric mucosa-associated lymphoid tissue lymphoma. Am J Gastroenterol 98:975–986, 2003CrossRefPubMedGoogle Scholar
  3. 3.
    Wotherspoon AC, Ortiz-Hidalgo C, Falzon MR, et al.: Helicobacter pylori-associated gastritis and primary B-cell gastric lymphoma. Lancet 338:1175–1176, 1991CrossRefPubMedGoogle Scholar
  4. 4.
    Eck M, Schmauber B, Haas R, et al.: MALT-type lymphoma of the stomach is associated with H. pyloristrains expressing the Cag A protein. Gastroenterology 112:1482–1486, 1997CrossRefPubMedGoogle Scholar
  5. 5.
    Crabtree JE, Spencer J: Immunological aspects of Helicobacter pyloriinfection and malignant transformation of B cells. Semin Gastrointest Dis 7:30–40, 1996PubMedGoogle Scholar
  6. 6.
    Rollinson S, Levene AP, Mensah FK, et al.: Gastric marginal zone lymphoma is associated with polymorphisms in genes involved in inflammatory response and antioxidative capacity. Blood 102:1007–1011, 2003CrossRefPubMedGoogle Scholar
  7. 7.
    Hellmig S, Vollenberg S, Fischbach W, et al.: IL-1 gene cluster polymorphisms and development of primary gastric B-cell lymphoma in Helicobacter pyloriinfection. Blood 104:2994–2995, 2004CrossRefPubMedGoogle Scholar
  8. 8.
    Wootherspoon AC, Doglioni C, Diss TC, et al.: Regression of primary low grade B-cell lymphoma of mucosa-associated lymphoid tissue. Lancet 342:575–577, 1993Google Scholar
  9. 9.
    Hammel P, Haioun C, Chaummette M, et al.: Efficacy of single agent chemotherapy in low grade B-cell MALT lymphoma with prominent gastric expression. J Clin Oncol 13:2524–2529, 1995PubMedGoogle Scholar
  10. 10.
    Iocher M, Muller R, Ross D, et al.: Radiotherapy for treatment of localized gastrointestinal non-Hodgkin’s lymphoma. Radiother Oncol 42:37–41, 1997Google Scholar
  11. 11.
    McLaughlin P, Grillo-Lopez A, link B, et al.: Rituximab chimeric anti-CD20 monoclonal antibody therapy for relapsed indolent lymphoma: Half of patients respond to a four dose treatment program. J Clin Oncol 16:2825–2833, 1998PubMedGoogle Scholar
  12. 12.
    Conconi A, Martinelli G, Thieblemont C, et al.: Clinical activity of rituximab in extranodal marginal zone B-cell lymphoma of MALT type. Blood 102:2741–2745, 2003CrossRefPubMedGoogle Scholar
  13. 13.
    Martinelli G, Laszlo D, Ferreri AJ, et al.: Clinical activity of rituximab in gastric marginal zone non-Hodgkin’s lymphoma resistant to or not eligible for anti-Helicobacter pylori therapy. J Clin Oncol 23:1979–1983, 2005CrossRefPubMedGoogle Scholar
  14. 14.
    Datta YH, Kampalath B, Binion DG: Rituximab-induced remission of a gastric MALT lymphoma. Leu Lymph 45:1297–1299, 2004Google Scholar
  15. 15.
    Nuckel H, Meller D, Steuhl KP, et al.: Anti-CD20 monoclonal antibody therapy in relapsed MALR lymphoma of the conjunctiva. Eur J Haematol 73:258–262, 2004CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science + Business Media, Inc. 2006

Authors and Affiliations

  • Nadeem Chaudhary
    • 1
  • Howard Ozer
    • 1
  • David Huard
    • 2
  • Stan Lightfoot
    • 3
  • Sikandar Mesiya
    • 4
    • 5
  1. 1.Divisions of Gastroenterology and Oncology, Department of MedicineUniversity of Oklahoma Health Sciences CenterOklahoma CityUSA
  2. 2.Divisions of Gastroenterology and Oncology, Department of RadiologyUniversity of Oklahoma Health Sciences CenterOklahoma CityUSA
  3. 3.Divisions of Gastroenterology and Oncology, Department of PathologyUniversity of Oklahoma Health Sciences CenterOklahoma CityUSA
  4. 4.Digestive Disease Specialists Inc.Oklahoma CityUSA
  5. 5.Digestive Disease Specialists Inc.Midwest City

Personalised recommendations