Korean J Hematol.  2011 Sep;46(3):203-206. 10.5045/kjh.2011.46.3.203.

A case of follicular B-cell lymphoma treated using clarithromycin

• Ohe M
• Hashino S

• KMID: 2252006
• DOI: http://doi.org/10.5045/kjh.2011.46.3.203

Abstract

We report a case of follicular B-cell lymphoma (FL) treated successfully using clarithromycin (CAM). A 44-year-old man who presented with lymphadenopathy was diagnosed with FL after a histological examination of his biopsy specimens. He was administered chemotherapy with R-CHOP (rituximab, cyclophosphamide, adriamycin, vincristine, and prednisolone) following which stable disease was achieved. However, the subsequent clinical course showed partial remission of FL and stable disease with tumor regrowth, each of which was treated with chemotherapeutic regimens. Since the patient was diagnosed with leukocytopenia, he could not undergo chemotherapy for the third regrowth; hence, he was administered CAM. His lymphadenopathy regressed and the levels of soluble interleukin 2-receptor decreased. This case shows that treatment using CAM may be effective in some cases of FL.

Keyword

B-cell lymphoma; Macrolide; Clarithromycin; Apoptosis; bcl-2

MeSH Terms

Adult
Apoptosis
B-Lymphocytes
Biopsy
Clarithromycin
Cyclophosphamide
Doxorubicin
Humans
Interleukins
Leukopenia
Lymphatic Diseases
Lymphoma, B-Cell
Vincristine
Clarithromycin
Cyclophosphamide
Doxorubicin
Interleukins
Vincristine

Figure

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  Fig. 1 Computed tomography. (A) Contrast-enhanced abdominal computed tomography (CT) image showing para-aortic lymphadenopathy at the time of admission. (B) Abdominal CT image showing para-aortic lymphadenopathy after completion of 6 cycles of R-CHOP chemotherapy (rituximab, cyclophosphamide, adriamycin, vincristine, and prednisolone). (C) Abdominal CT image showing para-aortic lymphadenopathy (first regrowth). (D) Abdominal CT image showing para-aortic lymphadenopathy after completion of 5 cycles of R-cladribine therapy. (E) Abdominal CT image showing para-aortic lymphadenopathy just before the first R-monotherapy. (F) Abdominal CT image showing para-aortic lymphadenopathy 5 months after completion of 4 cycles of R-monotherapy. (G) Abdominal CT showing para-aortic lymphadenopathy (second regrowth). (H) Abdominal CT image showing para-aortic lymphadenopathy after completion of 5 cycles of R-fludarabine therapy. (I) Abdominal CT image showing para-aortic lymphadenopathy (third regrowth). (J) Abdominal CT image showing par-aortic lymphadenopathy 3 months after initiation of clarithromycin (800 mg/day) treatment. (K) Abdominal CT image showing para-aortic lymphadenopathy 9 months after initiation of clarithromycin (800 mg/day) treatment.

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  Fig. 2 Histological and immunohistochemical examination of cervical lymph node biopsy specimens. (A) Histological examination showing well-circumscribed follicles consisting of a monotonous population of predominantly small-cleaved cells (Hematoxylin and eosin stain, ×100). (B) Immunohistochemical examination for bcl-2 showing positive staining in the small-cleaved cells (Immunohistochemical stain, ×400).

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  Fig. 3 Clinical course. sIL2-R, soluble interleukin 2 receptor; R, rituximab; C, cyclophosphamide; H, adriamycin; O, vincristine; P, prednisolone; CAM, clarithromycin.

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