Treatment of Localized Gastric MALT Lymphoma with Helicobacter pylori Infection
This protocol covers the management of gastric MALT-type (mucosa-associated lymphoid tissue) lymphoma at a localized, early stage in patients with confirmed Helicobacter pylori infection — a specific sub-population in which the infectious context directly shapes the treatment strategy.
Clinical Scenario
The defining feature of this presentation is active H. pylori infection identified concurrently with localized gastric MALT lymphoma. This combination places the patient in a well-studied group for whom a targeted first-line intervention is available.
Treatment Approach
The most widely accepted first-line strategy for this setting is targeted antimicrobial eradication therapy directed at H. pylori. The specific combination and duration are detailed in the full protocol — see below for complete access.
Clinical Goals
Eradication of H. pylori and complete remission of the gastric MALT lymphoma are the primary endpoints. Response is assessed by endoscopy performed 3 to 6 months after completion of treatment, which also confirms H. pylori status histologically.
References
Until now, the most widely accepted initial treatment option for localized disease is the eradication of H pylori using the triple therapy based on the combination of proton-pomp inhibitors (PPI), clarithromycin with either amoxicillin or metronidazole for 10 to 14 days.
Several studies have confirmed the effectiveness of antibiotic therapy with long-term remissions in 70% to 100% of patients with localized, H pylori-positive, MALT lymphomas.
To assess MALT lymphoma remission, a first endoscopy is performed 3 to 6 months after completion of antibacterial treatment, which also allows for checking of the H pylori status histologically.