title: Regression of ocular adnexal lymphoma after Chlamydia psittaci-eradicating antibiotic therapy.
abstract: 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.
authors.affiliation: Department of Radiochemotherapy, San Raffaele H Scientific Institute, Via Olgettina 60, 20132 Milan, Italy. andres.ferreri@hsr.it
authors.forename: Andrés J M
authors.initials: AJ
authors.lastname: Ferreri
authors.forename: Maurilio
authors.initials: M
authors.lastname: Ponzoni
authors.forename: Massimo
authors.initials: M
authors.lastname: Guidoboni
authors.forename: Carlo
authors.initials: C
authors.lastname: De Conciliis
authors.forename: Antonio Giordano
authors.initials: AG
authors.lastname: Resti
authors.forename: Benedetta
authors.initials: B
authors.lastname: Mazzi
authors.forename: Antonia Anna
authors.initials: AA
authors.lastname: Lettini
authors.forename: Judit
authors.initials: J
authors.lastname: Demeter
authors.forename: Stefania
authors.initials: S
authors.lastname: Dell'Oro
authors.forename: Claudio
authors.initials: C
authors.lastname: Doglioni
authors.forename: Eugenio
authors.initials: E
authors.lastname: Villa
authors.forename: Mauro
authors.initials: M
authors.lastname: Boiocchi
authors.forename: Riccardo
authors.initials: R
authors.lastname: Dolcetti
mesh_terms: 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*
chemical_list: D000900:Anti-Bacterial Agents; D004269:DNA, Bacterial; D004318:Doxycycline