Use of anti-infectious regimens in patients with MZLs
| Pathogen . | MZL subtype, organ . | Prevalence range (%) . | Anti-infectious regimen . | Type of evidence . | ORR (CR) . | PFS . | Notes . |
|---|---|---|---|---|---|---|---|
| Helicobacter pylori | EMZL, stomach | >90% | PPI, clarithromycin-based triple therapy with amoxicillin or metronidazolea | >30 retrospective or prospective studies; data from >1400 pts | 75% | 28 mo | Responses observed also in HP-negative cases (false-negative tests or other Helicobacter species) |
| Chlamydophila psittaci | EMZL, ocular adnexa | 0%-80% | Doxycyclineb or clarithromycinc | >10 retrospective and 3 prospective studies; data from >100 pts | 45%-65% | 55% at 5 y | Wide prevalence variability depending on geographical region |
| Borrelia burgdorferi | EMZL, skin | 0%-40% | Ceftriaxoned | Case reports | 40% | NA | Prevalence high in endemic areas; median 7.3% |
| Campylobacter jejuni | EMZL, small bowel (IPSID) | up to 60% | Tetracycline, metronidazole, or ampicillin | Case reports | NA | NA | Association with low socioeconomic and sanitation status |
| Achromobacter xylosoxidans | EMZL, lung | 2%-46% | NA | NA | NA | NA | Low virulence, highly resistant to antibiotics |
| Hepatitis C virus | EMZL, various nongastric sites; SMZL; NMZL | 5%-20% | DAAse | Retrospective studies, 1 prospective study | 48% (26%) | 73% at 3 y | ORR higher in EMZL |
| Pathogen . | MZL subtype, organ . | Prevalence range (%) . | Anti-infectious regimen . | Type of evidence . | ORR (CR) . | PFS . | Notes . |
|---|---|---|---|---|---|---|---|
| Helicobacter pylori | EMZL, stomach | >90% | PPI, clarithromycin-based triple therapy with amoxicillin or metronidazolea | >30 retrospective or prospective studies; data from >1400 pts | 75% | 28 mo | Responses observed also in HP-negative cases (false-negative tests or other Helicobacter species) |
| Chlamydophila psittaci | EMZL, ocular adnexa | 0%-80% | Doxycyclineb or clarithromycinc | >10 retrospective and 3 prospective studies; data from >100 pts | 45%-65% | 55% at 5 y | Wide prevalence variability depending on geographical region |
| Borrelia burgdorferi | EMZL, skin | 0%-40% | Ceftriaxoned | Case reports | 40% | NA | Prevalence high in endemic areas; median 7.3% |
| Campylobacter jejuni | EMZL, small bowel (IPSID) | up to 60% | Tetracycline, metronidazole, or ampicillin | Case reports | NA | NA | Association with low socioeconomic and sanitation status |
| Achromobacter xylosoxidans | EMZL, lung | 2%-46% | NA | NA | NA | NA | Low virulence, highly resistant to antibiotics |
| Hepatitis C virus | EMZL, various nongastric sites; SMZL; NMZL | 5%-20% | DAAse | Retrospective studies, 1 prospective study | 48% (26%) | 73% at 3 y | ORR higher in EMZL |
PPI (standard dose) twice daily + clarithromycin 500 mg twice daily + amoxicillin 1000 mg twice daily or metronidazole 500 mg twice daily, for 14 days.
Doxycycline 100 mg twice daily for 3 weeks.
Clarithromycin 500 mg twice daily for 6 months.
Ceftriaxone intravenously 2 g/d for 2 weeks.
Sofosbuvir/velpatasvir 400/100 mg/d for 12 weeks or glecaprevir/pibrentasvir 300/100 mg/d for 8 weeks (12 weeks for genotype 3).
CR, complete response; IPSID, immunoproliferative small intestine disease; NA, not available; PPI, proton pump inhibitor; pts, patients.