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Long-term outcomes of first-line treatment with doxycycline in patients with previously untreated ocular adnexal marginal zone B cell lymphoma

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Abstract

Ocular adnexal lymphoma (OAL) has been associated with Chlamydophila psittaci infection, for which doxycycline has been suggested as a treatment option. We conducted this study to evaluate the long-term results of first-line doxycycline treatment in patients with OAL. Ninety patients with histologically confirmed OAL with marginal zone B cell lymphoma were enrolled. Each patient received one or two cycles of doxycycline (100 mg bid) for 3 weeks. After a median follow-up period of 40.5 months (8–85), the 5-year progression-free survival (PFS) rate was 60.9 %. All patients were alive at the last follow-up date. Thirty-one patients (34 %) showed local treatment failure without systemic spread. However, PFS rate in these patients was 100 % after salvage chemotherapy and/or radiotherapy. PFS was independently predicted in multivariate analysis by the tumor-node-metastasis (TNM) staging (hazard ratio [HR], 4.35; 95 % confidence interval [CI], 2.03–9.32; P < 0.001) and number of cycles of doxycycline (HR, 0.31; 95 % CI, 0.14–0.69; P = 0.004). No serious adverse event was reported during doxycycline therapy. In conclusion, first-line doxycycline therapy was effective and safe. Patients who failed to respond to doxycycline therapy were successfully salvaged with chemotherapy and/or radiotherapy without compromising long-term outcomes. Patients with T1N0M0 disease could be considered good candidates for first-line doxycycline.

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Acknowledgments

This study was supported by a grant from the Innovative Research Institute for Cell Therapy, Republic of Korea (A062260).

Conflict of interest

The authors indicated no potential conflict of interest.

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Authors and Affiliations

  1. Department of Internal Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, South Korea

    Jae Joon Han, Tae Min Kim & Dae Seog Heo

  2. Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea

    Jae Joon Han, Tae Min Kim, Il Han Kim & Dae Seog Heo

  3. Department of Pathology, Seoul National University Hospital, Seoul, South Korea

    Yoon Kyung Jeon & Chul-Woo Kim

  4. Department of Ophthalmology, Seoul National University Hospital, Seoul, South Korea

    Mee Kum Kim & Sang In Khwarg

  5. Department of Radiation Oncology, Seoul National University Hospital, Seoul, South Korea

    Il Han Kim

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  1. Jae Joon Han
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Correspondence to Dae Seog Heo.

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Han, J.J., Kim, T.M., Jeon, Y.K. et al. Long-term outcomes of first-line treatment with doxycycline in patients with previously untreated ocular adnexal marginal zone B cell lymphoma. Ann Hematol 94, 575–581 (2015). https://doi.org/10.1007/s00277-014-2240-8

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  • DOI: https://doi.org/10.1007/s00277-014-2240-8

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