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


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.


CONCLUSIONS
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.
Ferreri
Andrés J M
AJ
Department of Radiochemotherapy, San Raffaele H Scientific Institute, Via Olgettina 60, 20132 Milan, Italy. andres.ferreri@hsr.it
Ponzoni
Maurilio
M
Guidoboni
Massimo
M
De Conciliis
Carlo
C
Resti
Antonio Giordano
AG
Mazzi
Benedetta
B
Lettini
Antonia Anna
AA
Demeter
Judit
J
Dell'Oro
Stefania
S
Doglioni
Claudio
C
Villa
Eugenio
E
Boiocchi
Mauro
M
Dolcetti
Riccardo
R
D000284:Administration, Oral; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002691:Chlamydophila psittaci / Q000235:genetics / Q000472:pathogenicity*; D004269:DNA, Bacterial / Q000032:analysis; D004318:Doxycycline / Q000627:therapeutic use*; D005134:Eye Neoplasms / Q000188:drug therapy* / Q000382:microbiology*; D005260:Female; D006801:Humans; D007963:Leukocytes, Mononuclear / Q000382:microbiology; D016393:Lymphoma, B-Cell / Q000188:drug therapy* / Q000382:microbiology*; D008297:Male; D008875:Middle Aged; D009956:Psittacosis / Q000150:complications* / Q000188:drug therapy*
D000900:Anti-Bacterial Agents; D004269:DNA, Bacterial; D004318:Doxycycline