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

C. S. Portlock, P. Hamlin, A. Noy, W. Chey, C. A. Gaydos, L. Palomba, I. Schwartz, S. Corcoran, L. Rosenzweig, D. Walker, G. Papanicolaou, A. Markowitz

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
Pages (from-to)254-258
Number of pages5
JournalAnnals of Oncology
Volume19
Issue number2
DOIs
StatePublished - Feb 2008

Keywords

  • Follicular lymphoma
  • Indolent lymphoma
  • Infections
  • Prevention

ASJC Scopus subject areas

  • Hematology
  • Oncology

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    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. (2008). Infectious disease associations in advanced stage, indolent lymphoma (follicular and nonfollicular): Developing a lymphoma prevention strategy. Annals of Oncology, 19(2), 254-258. https://doi.org/10.1093/annonc/mdm484