Table 4. IPSID treatment and related outcomes.
| Galian stage | Category | Treatment | Dose / Duration | Outcome | n | Ref |
|---|---|---|---|---|---|---|
| A | Antibiotics | Tetracycline | - | PR or CR (n = 24), transformation into diffuse large B-cell lymphoma (n = 3) | 27 | [2] |
| - | PR in 1-year follow up. Transformation into malignant lymphoma and death. | 1 | [15] | |||
| 6 months | - | 1 | [17] | |||
| 1 g daily | 71% CR, 43.5% 5 year disease free survival | 7 | [32] | |||
| 2 g daily for 6–24 months | 33–70% CR | - | [39] | |||
| Tetracycline or metronidazole and ampicillin | - | Overall remission rate of 90% in 2 years, 67% in 3 years | 6 | [32] | ||
| Tetracycline, ampicillin and/or metronidazole | - | PR, 33–71% of response | - | [6] | ||
| 6 months | - | - | [33, 37] | |||
| Tetracycline, ampicillin, metronidazole | 42–55 months | PR | - | [36] | ||
| Doxycycline | 6 months | CR in 7-year follow up | 1 | [18] | ||
| 200 mg daily for 6 months | CR in 6-month follow up | 1 | [25] | |||
| 200 mg daily | PR | 1 | [28] | |||
| Amoxacillin, metronidazole and pantoprazole | 4 months | PR | 1 | [23] | ||
| Azithromycin, metronidazole | 6 months | CR in 6-month follow up | 1 | [14] | ||
| H. pylori eradication therapy: Amoxicillin, clarithromycin, lansoprazole. Followed by amoxicillin, tinidazole, omeprazole and bismuth subcitrate. | 500mg, 500 mg, and 30 mg for 7 days. Then, 1 g, NS, NS, and 20 mg for 14 days | CR in 6-month follow up | 1 | [18] | ||
| H. pylori eradication therapy | - | - | 1 | [22] | ||
| C. jejuni eradication therapy: Amoxicillin, metronidazole, clarithromycin and omeprazole. | 1 g twice daily, 500 mg twice daily, 500 mg twice daily, and 20 mg twice daily for 5 months. | CR in 5-month follow up | 1 | [19] | ||
| Corticosteroid | Prednisone | 40 mg daily for 1 month | CR | 1 | [5] | |
| 30 years | PR for 30 years, death due to total intestinal obstruction | 1 | [10] | |||
| Supplements | Vitamin D, calcium, magnesium, potassium, iron, folic acid, mecobalamin, and microflora probiotics. | 1 month | PR | 1 | [5] | |
| Nutritional support, vitamins and mineral supplementation. | 6 months | CR in 6-month follow up | 1 | [14] | ||
| Gluten-free diet | - | PR in 1-year follow up. Transformation into malignant lymphoma and death. | 1 | [15] | ||
| B or C | Surgery | Hemicolectomy and lymphadenectomy | - | CR, 5-year follow up | 1 | [13] |
| Laparotomy | - | Post-surgery complications and death | 1 | [16] | ||
| Whipple procedure, CHOP and anti-CD20 antibody | 5 days every 3 weeks | CR in 9-month follow up | 1 | [24] | ||
| Chemotherapy | Tetracycline, CHOP | - 500 mg twice daily for 2 months, one cycle | Death by intestinal perforation | 1 | [26] | |
| Doxycycline, CHOP | - 10–16 months, 6 cycles | CR (n = 6), intestinal obstruction complication (n = 2), death (n = 3). | 11 | [8] | ||
| CHOP, CHOP with tetracycline, antibiotics with doxycycline and metronidazole | - | CR (n = 3), transformation into high-grade B-cell lymphoma (n = 1) and death (n = 2). | 6 | [21] | ||
| COPP, tetracycline | 1 g daily for 6 months | CR in 11 patients (68.75%) | 16 | [11] | ||
| THP-COP, R-P-IMVP16/CBDCA, R-CdA | 6 cycles, 2 cycles, NS | PR, transformation into T-cell lymphoma in 2-year follow up and death. | 1 | [20] | ||
| COP with antibiotics, or metronidazole with tetracycline, or antibiotics with metronidazole and doxycycline | - | CR (n = 3), transformation into high-grade B-cell lymphoma (n = 1) and death (n = 2). | 6 | [21] | ||
| CHOP | 6 cycles | - | 3 | [2] | ||
| 3 cycles | PR, chemotherapy complications | 1 | [27] | |||
| CHOP, tetracycline, and granulocyte stimulating factor | - | CR in 12-month follow up | 1 | [26] | ||
| CHOP, maintenance therapy with tetracycline | 6 cycles, 500 mg twice daily for 56 months | PR, transformation into lymphoma, CR in 56-month follow up. | 1 | [22] | ||
| Anthracycline-based chemotherapy | - | Overall remission rate of 90% in 2 years, 67% in 3 years | 15 | [32] | ||
| CHOP, ABV or CHVP | - | 67% 5-year survival | - | [6] | ||
| CHOP, EPOCH, CVAD OR RD-CODOX-M/IVAC | - | Fatal within 2 years | - | [30] | ||
| C | Immunotherapy | Rituximab, R2-CHOP | 4 cycles, 6 cycles | PR, transformation into diffuse large B-cell lymphoma | 1 | [7] |
| Rituximab | 375 mg/m2 weekly for 4 weeks | 46% CR in patients with lymphoma, 7.7%relapse in 33-month follow up. | 27 | [40] |
Abbreviations: n: number of patients, CR: complete remission, PR: partial remission, NS: not specified; CHOP: cyclophosphamide, doxorubicine, vincristine, prednisolone, R2-CHOP = rituximab, lenalidomide, cyclophosphamide, doxorubicin, vincristine, and prednisone; COP: cyclophosphamide, vincristine, prednisolone; THP-COP: pirarubicin, cyclophosphamide, vincristine, and prednisolone; R-P-IMVP16/CBDCA: rituximab, methylprednisolone, ifosfamide, methotrexate, etoposide, and carboplatin; R-CdA: rituximab and cladribine; EPOCH: etoposide, prednisone, oncovin, cyclophosphamide, hydroxydaunorubicin; CVAD: vincristine, adriamycin, dexamethasone; RD-CODOX-M/IVAC: Rituximab, depocytarabine,cyclophosphamide, oncovin, doxorubicin, methotrexate/ifosfamide, vp16etoposide, aracytarabine.