What treatment is indicated for low-grade gastric MALT lymphoma associated with H. pylori?

For low-grade gastric MALT lymphoma associated with Helicobacter pylori infection, the first-line treatment involves eradicating the H. pylori. This is crucial because most cases of MALT lymphoma are considered to be driven by this infection. The appropriate regimen typically includes a proton pump inhibitor (PPI) along with two antibiotics to effectively achieve this eradication.

Specifically, the combination of a PPI, clarithromycin, and amoxicillin is a standard triple therapy for H. pylori eradication. This regimen is effective due to the complementary mechanisms of action of the antibiotics, which target the bacterium in different ways and enhance the likelihood of successfully clearing the infection. Additionally, the PPI helps reduce gastric acidity, thereby improving the efficacy of the antibiotics.

When H. pylori is eradicated in patients with low-grade gastric MALT lymphoma, there is often a significant response, which may lead to remission of the lymphoma itself. Thus, initiating treatment with this eradication regimen is not only critical for addressing the infection but also for managing the associated lymphoma.

In contrast, options that suggest surveillance without treatment or surgery alone are not the recommended approaches in this scenario, as they do not address the underlying cause of lymphoma, which is typically