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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