Regression of ocular adnexal lymphoma after Chlamydia psittaci-eradicating antibiotic therapy.

Abstract

PURPOSE:

Some infectious agents contributing to lymphomagenesis have been considered targets for new therapeutic strategies. Chlamydia psittaci DNA has been detected in 80% of ocular adnexal lymphomas. The present pilot study was carried out to assess whether C psittaci-eradicating antibiotic therapy is associated with tumor regression in ocular adnexal lymphomas.

PATIENTS AND METHODS:

Nine patients with C psittaci-positive marginal-zone B-cell lymphoma of the ocular adnexa at diagnosis or relapse were treated with doxycycline 100 mg, bid orally, for 3 weeks. The presence of C psittaci DNA in peripheral-blood mononuclear cells (PBMCs) was also assessed before and after treatment in seven patients. Objective lymphoma regression was assessed 1, 3, and 6 months after therapy conclusion and every 6 months during follow-up.

RESULTS:

All patients completed antibiotic therapy with excellent tolerability. At 1 month from doxycycline assumption, chlamydial DNA was no longer detectable in PBMCs of all four positive patients. Objective response was complete in two patients, partial response (> 50%) was observed in two patients, and minimal response (< 50%) was observed in three patients. Duration of response in the seven responders was 12+, 29+, 31+, 8+, 7+, 2+, and 1+ months, respectively.

CONCLUSION:

C psittaci-eradicating antibiotic therapy with doxycycline is followed by objective response in patients with ocular adnexal lymphoma, even after multiple relapses of the disease. A confirmatory, large, phase II trial is warranted to confirm whether this fast, cheap, and well-tolerated therapy could replace other more aggressive strategies as first-line treatment against ocular adnexal lymphomas.

• Authors: Andrés J M Ferreri, Maurilio Ponzoni, Massimo Guidoboni, Carlo De Conciliis, Antonio Giordano Resti, Benedetta Mazzi, Antonia Anna Lettini, Judit Demeter, Stefania Dell'Oro, Claudio Doglioni, Eugenio Villa, Mauro Boiocchi, Riccardo Dolcetti
• Journal: Journal of clinical oncology : official journal of the American Society of Clinical Oncology (J Clin Oncol) Vol. 23 Issue 22 Pg. 5067-73 (Aug 01 2005) ISSN: 0732-183X [Print] United States
• PMID: 15968003 (Publication Type: Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Anti-Bacterial Agents
• DNA, Bacterial
• Doxycycline

Topics

• Administration, Oral
• Aged
• Anti-Bacterial Agents (administration & dosage, therapeutic use)
• Chlamydophila psittaci (genetics, pathogenicity)
• DNA, Bacterial (analysis)
• Doxycycline (therapeutic use)
• Eye Neoplasms (drug therapy, microbiology)
• Female
• Humans
• Leukocytes, Mononuclear (microbiology)
• Lymphoma, B-Cell (drug therapy, microbiology)
• Male
• Middle Aged
• Psittacosis (complications, drug therapy)