MALToma: a Helicobacter pylori-associated malignancy in transplant patients: a report from the Israel Penn International Transplant Tumor Registry with a review of published literature

TitleMALToma: a Helicobacter pylori-associated malignancy in transplant patients: a report from the Israel Penn International Transplant Tumor Registry with a review of published literature
Publication TypeJournal Article
Year of Publication2003
AuthorsAull MJ, Buell JF, Peddi VR, Trofe J, Beebe TM, Hanaway MJ, Roy-Chaudhury P, Alloway RR, First MR, Woodle ES
JournalTransplantation
Volume75
Issue2
Pagination225 - 8
Date PublishedJan 27
Accession Number12548128
Keywords*Helicobacter pylori, Adult, Female, Heart Transplantation / adverse effects, Helicobacter Infections / *complications, Humans, Kidney Transplantation / adverse effects, Liver Transplantation / adverse effects, Lymphoma, Mucosa-Associated Lymphoid Tissue / *etiology, Middle Aged, Organ Transplantation / *adverse effects
Abstract

BACKGROUND: Mucosa-associated lymphoid tissue lymphoma (MALToma) is a Helicobacter pylori-related tumor of B-cell origin, the malignant potential for which remains to be defined in immunosuppressed patients. METHODS: Review of the Israel Penn International Transplant Tumor Registry identified six cases of gastric MALToma. Patient demographics, management, and outcomes were compared and published literature was reviewed. RESULTS: MALToma developed in six transplant recipients (three kidney, two heart, one kidney-pancreas). All were treated with immunosuppression minimization and therapy for H. pylori, resulting in disease regression in five patients. One patient developed progression to high-grade MALToma despite documented H. pylori eradication, required surgery and chemotherapy, and died, with significant disease at autopsy. CONCLUSIONS: Treatment of MALToma with immunosuppression minimization and anti-H. pylori therapy results in a majority of patients becoming disease free. Observation of malignant degeneration into an aggressive, high-grade lymphoma in one patient indicates the malignant potential. Diligent follow-up of these patients with endoscopy and biopsy is therefore indicated.

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