ما هو علاج ليمفوما MALT للمعدة؟ بروتوكول الخط الأول

References

DOI: 10.3390/cancers15153811

• The first line of treatment in all cases, independently of H. pylori status and of the disease stage, is an H. pylori eradication therapy.
• In particular, the detection of clarithromycin resistance by RT-PCR must be encouraged since, in case of a strain susceptible to clarithromycin, an optimized triple therapy (amoxicillin 3 × 1 g + clarithromycin 2 × 500 mg + esomeprazole 3 × 40 mg/day for 14 days) may be proposed.
• If antimicrobial susceptibility testing is not feasible, or the bacterial strain is resistant to clarithromycin, the first-line empirical treatment by Pylera® should be proposed.
• The optimal duration of treatment is now established at 14 days, with the exception of Pylera® (association of bismuth subcitrate + metronidazole + tetracycline), which is administered together with omeprazole for 10 days.
• The efficacy of the eradication treatment must always be verified, the best by the urea breath test performed at least 6 weeks after cessation of treatment.
• The response to treatment is evaluated endoscopically by showing a regression of macroscopic lesions (i.e., ulcers), if present initially, at control endoscopy, and histologically, showing a histological regression of lymphocytic infiltration of gastric mucosa, the best evaluated according to the GELA classification.