Doxycycline Seen Effective for Lymphoma of the Eye

NEW YORK OCT 03, 2006 (Reuters Health) - Doxycycline is a "fast, safe, and active" therapy for ocular adnexal lymphoma (OAL) of the MALT type, both initially and in the case of relapse, clinicians report in the current issue of the Journal of the National Cancer Institute dated October 4.

"Although OAL is rarely lethal and is sometimes manageable with watchful observation alone, it frequently needs treatment because it can cause symptoms that compromise the patient"s quality of life," Dr. Andres J. M. Ferreri, from San Raffaele H Scientific Institute in Milan and colleagues note in their report.

A strong association between OAL and Chlamydia psittaci infection has been reported by Dr. Ferreri"s group and others.  Ties to Chlamydia raise the possibility that antibiotics may be an effective approach for OAL patients, as proved to be the case for gastric MALT lymphomas, for which Helicobacter pylori eradication is now the norm.

Accordingly, Dr. Ferreri and colleagues treated 27 patients with OAL with a three-week course of doxycycline.  Fifteen of the patients had newly diagnosed OAL and 12 had experienced relapse. 

At a median follow up of 14 months, six patients had complete tumor regression and seven had partial tumor regression, for an overall response rate of 48%.

Doxycycline was effective "even in patients with multiple failures involving previously irradiated areas or regional lymphadenopathies," Dr. Ferreri and colleagues report. 

The 2-year disease-free survival rate with doxycycline treatment was 66%.

Of note, lymphoma regression was observed in 7 of 11 patients (64%) positive for C. psittaci, as well as in 6 of 16 negative patients (38%). "The objective responses seen in C. psittaci-negative OAL," the researchers say, "may suggest that doxycycline should be used in every OAL patient independently of C. psittaci infection assessment."

Objective responses in C. psittaci-negative OAL also "raise questions about the possible role of other doxycycline-sensitive microorganisms in the pathogenesis of OAL," the investigators note. 

In an editorial, Dr. Emanuel Zucca and Francesco Bertoni of the Oncology Institute of Southern Switzerland write, "While doxycycline appears to be an easy-to-implement therapeutic approach, we strongly encourage all physicians to enroll patients in clinical prospective trials to help answer these questions."

SOURCE;

• J Natl Cancer Inst 2006;98:1348-1349,1375-1382.