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Diffuse large B cell gastric lymphoma a rare disease: the effort to obtain scientific data in a multicenter, multinational retrospective trial☆

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      Helicobacter pylori infection and gastric lymphoma.

      Helicobacter pylori infection is a risk factor for gastric adenocarcinoma. We examined whether this infection is also a risk factor for primary gastric non-Hodgkin's lymphoma. This nested case-control study involved two large cohorts (230,593 participants). Serum had been collected from cohort members and stored, and all subjects were followed for cancer. Thirty-three patients with gastric non-Hodgkin's lymphoma were identified, and each was matched to four controls according to cohort, age, sex, and date of serum collection. For comparison, 31 patients with nongastric non-Hodgkin's lymphoma from one of the cohorts were evaluated, each of whom had been previously matched to 2 controls. Pathological reports and specimens were reviewed to confirm the histologic type of the tumor. Serum samples from all subjects were tested for H. pylori IgG by an enzyme-linked immunosorbent assay. Thirty-three cases of gastric non-Hodgkin's lymphoma occurred a median of 14 years after serum collection. Patients with gastric lymphoma were significantly more likely than matched controls to have evidence of previous H. pylori infection (matched odds ratio, 6.3; 95 percent confidence interval, 2.0 to 19.9). The results were similar in both cohorts. Among the 31 patients with nongastric lymphoma, a median of six years had elapsed between serum collection and the development of disease. No association was found between nongastric non-Hodgkin's lymphoma and previous H. pylori infection (matched odds ratio, 1.2; 95 percent confidence interval, 0.5 to 3.0). Non-Hodgkin's lymphoma affecting the stomach, but not other sites, is associated with previous H. pylori infection. A causative role for the organism is plausible, but remains unproved.
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        Occurrence and prognosis of extranodal lymphomas.

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          Report on a workshop convened to discuss the pathological and staging classifications of gastrointestinal tract lymphoma.

          It was considered timely to review the pathological and staging classifications of GI tract lymphoma. This meeting specifically did not address the question of treatment; the management of GI tract lymphoma could perhaps form the basis for a further workshop. The following recommendations were made: to adopt the Isaacson histological classification, that all patients with GI tract lymphoma be investigated uniformly, to record the prognostic factors described above, to use the staging classification shown above. It is hoped that these recommendations will be taken into account in the design of future clinical trials of therapy for GI tract lymphoma.

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            Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
            Author notes
            [* ] Corresponding author at: Centro de Pesquisa Clínica, Instituto Israelita de Ensino e Pesquisa Albert Einstein, Av. Albert Einstein, 627/520, 05651-901 São Paulo, SP, Brazil. hamer@
            Rev Bras Hematol Hemoter
            Rev Bras Hematol Hemoter
            Revista Brasileira de Hematologia e Hemoterapia
            Sociedade Brasileira de Hematologia e Hemoterapia
            23 June 2016
            Jul-Sep 2016
            23 June 2016
            : 38
            : 3
            : 186-187
            © 2016 Associaç˜ao Brasileira de Hematologia, Hemoterapia e Terapia Celular. Published by Elsevier Editora Ltda.

            This is an open access article under the CC BY-NC-ND license (

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