Infectious disease associations in advanced stage, indolent lymphoma (follicular and nonfollicular): Developing a lymphoma prevention strategy Journal Article


Authors: Portlock, C. S.; Hamlin, P.; Noy, A.; Chey, W.; Gaydos, C. A.; Palomba, L.; Schwartz, I.; Corcoran, S.; Rosenzweig, L.; Walker, D.; Papanicolaou, G.; Markowitz, A.
Article Title: Infectious disease associations in advanced stage, indolent lymphoma (follicular and nonfollicular): Developing a lymphoma prevention strategy
Abstract: Background: Eradication of Helicobacter pylori in gastric mucosa-associated lymphoid tumor can result in lymphoma remission. We prospectively identified/treated infections in nonbulky, advanced stage indolent lymphoma (follicular; nonfollicular lymphoma) eligible for observation. Materials and methods: Stool H. pylori , hepatitis C and Borrelia serologies, Borrelia and Chlamydia fixed tissue PCR, Chlamydia peripheral blood mononuclear cell PCR and hydrogen breath test for small bowel bacterial overgrowth (SBBO) were obtained. Results: Fifty-six patients were enrolled. Positive infections: H. pylori (13); hepatitis C (3); SBBO (11). Negative: Borrelia (13); Chlamydophila psittaci (12, except one PCR). Lymphoma responses to antimicrobial therapy: H. pylori [one complete response (CR), 24+ months; one transient near CR]; hepatitis C [two CRs, 18+ and 30+ months; one partial response (PR) but hepatitis C virus persistent]; SBBO (one PR, 30+ months). Patients with associated infections, but without lymphoma CR, have required lymphoma treatment sooner than those without initial infections (treatment-free survival at 23.4 months median follow-up, 40.5% versus 74.7%, P = 0.01), indicating a different biology. Conclusion: Infections are common in advanced stage indolent lymphoma (37.5% in our series). Anecdotal lymphoma responses have been seen and three have been durable CRs (18 to 30+ months) with infection eradication alone. The identification and treatment of associated infections may be a first step towards developing a lymphoma prevention strategy. © 2007 European Society for Medical Oncology.
Keywords: immunohistochemistry; adult; cancer survival; treatment outcome; treatment response; aged; middle aged; survival analysis; major clinical study; advanced cancer; hepatitis c; disease free survival; cancer staging; outcome assessment; follow-up studies; neoplasm staging; prospective studies; disease association; cancer prevention; risk assessment; antiinfective agent; anti-bacterial agents; lymphoma; analysis of variance; bacterium identification; stomach neoplasms; follicular lymphoma; statistics, nonparametric; helicobacter infections; helicobacter pylori; antimicrobial therapy; prevention; eradication therapy; helicobacter infection; infections; superinfection; indolent lymphoma; hydrogen breath test; nonfollicular lymphoma; virus diagnosis; gastric mucosa; lymphoma, b-cell, marginal zone
Journal Title: Annals of Oncology
Volume: 19
Issue: 2
ISSN: 0923-7534
Publisher: Oxford University Press  
Date Published: 2008-02-01
Start Page: 254
End Page: 258
Language: English
DOI: 10.1093/annonc/mdm484
PUBMED: 17965114
PROVIDER: scopus
DOI/URL:
Notes: --- - "Cited By (since 1996): 2" - "Export Date: 17 November 2011" - "CODEN: ANONE" - "Source: Scopus"
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MSK Authors
  1. Carol Portlock
    181 Portlock
  2. Arnold J Markowitz
    109 Markowitz
  3. Ariela Noy
    208 Noy
  4. Maria Lia Palomba
    128 Palomba
  5. Paul Hamlin
    174 Hamlin
  6. Darren A Walker
    2 Walker