Treatment of Localized Gastric MALT-Type Lymphoma with Helicobacter pylori Infection

This protocol addresses primary gastric lymphoma presenting as mucosa-associated lymphoid tissue (MALT)-type lymphoma at a localized or early stage, specifically in the setting of confirmed Helicobacter pylori infection.

Clinical Scenario

Helicobacter pylori infection is a defining feature of this scenario. In localized, H. pylori-positive gastric MALT lymphoma, eradication of H. pylori is the widely accepted initial step, with studies confirming long-term remissions in the majority of patients following antibiotic-based eradication therapy. When this approach does not yield the intended outcome, a structured systemic treatment pathway applies.

Treatment Approach & Goal

For patients whose localized gastric MALT lymphoma does not achieve complete remission after initial treatment, systemic immunotherapy — alone or in combination with chemotherapy — is a recognised option. The protocol defines specific regimen choices and the conditions under which each applies.

Full regimen details, eligibility criteria, and sequencing are in the structured protocol →

Instant Access to Structured Evidence-Based Regimens

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.

Patients with localized disease, who did not respond to antibiotic therapy or radiation therapy, should be considered for systemic chemotherapy.

View source ↗