1215 Helicobacter pylori Infection in Cancer Patients: MD Anderson Cancer Center Experience

Abstract

INTRODUCTION: Helicobacter Pylori infection is prevalent worldwide. Up to 50% of the world population is affected, with or without symptoms. H. pylori infection can lead to gastritis, gastric or duodenal ulcers, gastric cancer, and rarely gastric mucosa-associated lymphoid-tissue lymphoma. Patients with cancer are exposed to several factors that can affect H. pylori behavior, such as chemotherapy, radiotherapy, and other treatment modalities. Also, the diminished immunity of cancer patients might be a risk factor for H. pylori or play a role in the responsiveness of H. pylori disease to treatment. Nonetheless, clinical features and outcomes of H. pylori in cancer patients are not well studied. We aimed to describe clinical symptoms, treatments, and outcomes of H. pylori in cancer patients. METHODS: We retrospectively collected information from adult cancer patients who had a diagnosis of H. Pylori after cancer diagnosis between January 2010 and November 2018. Descriptive statistics were used to summarize the data. T-tests and Pearson's Chi-Square were used to compare variables by cancer type. RESULTS: A total of 101 cancer patients diagnosed with H. Pylori by gastric biopsies were included, 61 males and 40 females with a mean age of 58.82 years. Asian was the most common race (n = 28), followed by Hispanic (n = 20) and White (n = 20). Reflux disease was present in 52 patients, hiatal hernia in 19, and Barrett's esophagus in 13. The most common cancer type was those of the gastrointestinal tract (n = 45), followed by lymphoma (n = 16) and breast (n = 14). Regarding cancer treatment, 15 patients had surgery, 51 had chemotherapy, and 35 had chemoradiation. The most common presenting symptom was abdominal pain (n = 45) then bloating (n = 30). Complications of H. pylori infection were manifested as gastric ulcer in 7 patients, duodenal ulcer in 3 and Gastrointestinal bleeding in 4. H. Pylori was treated with Prevpac in 45 patients and Pylera in 36. A 72 patients had response to treatment with the infection recurred in 14 patients. CONCLUSION: In cancer patients with H. Pylori infection, Asian was the most common race, abdominal pain was the most common presenting symptom, GI cancer was the most common malignancy followed by lymphoma and breast cancer. 71% had responded to the treatment.