Long-term persistence of monoclonal B cells after cure of Helicobacter pylori infection and complete histologic remission in gastric mucosa-associated lymphoid tissue B-cell lymphoma

被引:80
作者
Thiede, C [1 ]
Wündisch, T
Alpen, B
Neubauer, B
Morgner, A
Schmitz, M
Ehninger, G
Stolte, M
Bayerdörffer, E
Neubauer, A
机构
[1] Tech Univ Dresden, Klinikum Carl Gustav Carus, Med Klin & Poliklin 1, Dresden, Germany
[2] Univ Marburg, Abt Hamatol Onkol & Immunol, Marburg, Germany
[3] Tech Univ Dresden, Inst Immunol, D-8027 Dresden, Germany
[4] Klinikum Bayreuth, Inst Pathol, Bayreuth, Germany
关键词
D O I
10.1200/JCO.2001.19.6.1600
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose: Cure of Helicobacter pylori infection is associated with remission induction in the majority of patients with low-grade gastric mucosa associated lymphoid tissue (MALT) lymphoma in localized stages; however, limited data exist as to whether these patients may be cured of their lymphoma. The present study was performed to investigate whether the polymerase chain reaction (PCR) for the rearranged immunoglobulin heavy chain region may be used to define "molecular" remission. Patients and Methods: Ninety-seven patients who suffered from low-grade gastric MALT lymphoma stage I, were observed with central pathology and molecular biology after cure of H Pylori infection. PCR was performed with the use of consensus primers for the framework regions 1, 2, and 3 and monoclonality was corroborated by sequence analysis. In selected cases, microdissection was performed to study the origin of the monoclonal B cells. Results: Of the 97 patients, 77 obtained complete endoscopic and histologic remission (CR). Twenty of 44 patients with PCR monoclonality at diagnosis and with sufficient molecular follow-vp displayed monoclonal bands for a median time of 20.5 months after CR (range, 0 to 50.4 months). These B cells were related to the original lymphoma clone by sequence analysis. Microdissection analysis identified basal lymphoid aggregates as the source of these monoclonal B cells. Local relapse occurred in and was observed by PCR in four patients. All four patients displayed monoclonal PCR before relapse, and three of these four showed ongoing PCR monoclonality throughout their course, indicating the persistence of malignant cells. Conclusion: Half of all patients with gastric MALT lymphoma show long-term PCR monoclonality up to several years after cure of H pylori infection and CR. Patients with monoclonal PCR should be observed closely, whereas long term PCR negativity may indicate cure of the disease. (C) 2001 by American Society of Clinical Oncology.
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页码:1600 / 1609
页数:10
相关论文
共 38 条
[1]   Translocation t(11;18) absent in early gastric marginal zone B-cell lymphoma of MALT type responding to eradication of Helicobacter pylori infection [J].
Alpen, B ;
Neubauer, A ;
Dierlamm, J ;
Marynen, P ;
Thiede, C ;
Bayerdörffer, E ;
Stolte, M .
BLOOD, 2000, 95 (12) :4014-4015
[2]  
AUBIN J, 1995, LEUKEMIA, V9, P471
[3]   REGRESSION OF PRIMARY GASTRIC LYMPHOMA OF MUCOSA-ASSOCIATED LYMPHOID-TISSUE TYPE AFTER CURE OF HELICOBACTER-PYLORI INFECTION [J].
BAYERDORFFER, E ;
NEUBAUER, A ;
RUDOLPH, B ;
THIEDE, C ;
LEHN, N ;
EIDT, S ;
STOLTE, M .
LANCET, 1995, 345 (8965) :1591-1594
[4]   The apoptosis inhibitor gene API2 and a novel 18q gene, MLT, are recurrently rearranged in the t(11;18)(q21;q21) associated with mucosa-associated lymphoid tissue lymphomas [J].
Dierlamm, J ;
Baens, M ;
Wlodarska, I ;
Stefanova-Ouzounova, M ;
Hernandez, JM ;
Hossfeld, DK ;
De Wolf-Peeters, C ;
Hagemeijer, A ;
Van den Berghe, H ;
Marynen, P .
BLOOD, 1999, 93 (11) :3601-3609
[5]  
Du MQ, 2000, BLOOD, V95, P3885
[6]   PREVALENCE OF LYMPHOID FOLLICLES AND AGGREGATES IN HELICOBACTER-PYLORI GASTRITIS IN ANTRAL AND BODY MUCOSA [J].
EIDT, S ;
STOLTE, M .
JOURNAL OF CLINICAL PATHOLOGY, 1993, 46 (09) :832-835
[7]  
El-Zimaity HMT, 1999, MODERN PATHOL, V12, P885
[8]  
GREINER A, 1994, LAB INVEST, V70, P572
[9]   Minimal residual disease after intensive induction therapy in childhood acute lymphoblastic leukemia predicts outcome [J].
Gruhn, B ;
Hongeng, S ;
Yi, H ;
Hancock, ML ;
Rubnitz, JE ;
Neale, GAM ;
Kitchingman, GR .
LEUKEMIA, 1998, 12 (05) :675-681
[10]   The status of p53 in the metastatic progression of colorectal cancer [J].
Heide, I ;
Thiede, C ;
Sonntag, T ;
deKant, E ;
Neubauer, A ;
Jonas, S ;
Peter, FJ ;
Neuhaus, P ;
Herrmann, R ;
Huhn, D ;
Rochlitz, CF .
EUROPEAN JOURNAL OF CANCER, 1997, 33 (08) :1314-1322