Letter to the Editor

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Blood Res 2016; 51(2):

Published online June 23, 2016

https://doi.org/10.5045/br.2016.51.2.139

© The Korean Society of Hematology

Successful treatment of angioimmunoblastic T-cell lymphoma with clarithromycin

Masashi Ohe1*, and Satoshi Hashino2

1Department of General Medicine, JCHO Hokkaido Hospital, Sapporo, Japan.

2Health Care Center, Hokkaido University, Sapporo, Japan.

Correspondence to : Masashi Ohe. Department of General Medicine, JCHO Hokkaido Hospital, 1-8-3-18 Nakanoshima, Toyohira-ku, Sapporo 062-8618, Japan. masshi@isis.ocn.ne.jp

Received: May 30, 2015; Accepted: July 25, 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Fig. 1.

Cervical computed tomography (CT) images. (A) Cervical CT reveals right cervical lymphadenopathy. (B) Cervical enhanced CT reveals considerable improvement in right cervical lymphadenopathy after 3 cycles of chemotherapy with tetrahydropyranyl doxorubicin (50 mg on day 1), cyclophosphamide (750 mg on day 1), vincristine (1.6 mg on day 1), and prednisolone (50 mg on days 1–5). (C) Cervical CT reveals complete resolution of the right cervical lymphadenopathy at 6 months after clarithromycin add-on therapy.


Fig. 2.

Cervical histopathology and immunohistochemical images. (A) A right cervical lymph node biopsy specimen reveals effacement of the normal architecture with abundant pleomorphic cells and marked proliferation of arborizing high endothelial venules (hematoxylin and eosin stain, ×100). (B) Pleomorphic cells composed of lymphocytes, eosinophils, and atypical cells with intermediate-sized nuclei and clear cytoplasm are evident (hematoxylin and eosin stain, ×400). (C) Immunohistochemical examination shows CD3 positive staining in lymphocytes and atypical cells (×400). (D) A bone marrow aspiration smear reveals normal bone marrow (May-Giemsa stain, ×100).


  1. Ishimatsu, Y, Mukae, H, Matsumoto, K, et al. Two cases with pulmonary mucosa-associated lymphoid tissue lymphoma successfully treated with clarithromycin. Chest, 2010;138;730-733.
    Pubmed
  2. Ohe, M, Hashino, S. A case of follicular B-cell lymphoma treated using clarithromycin. Korean J Hematol, 2011;46;203-206.
    Pubmed
  3. Ohe, M, Hashino, S, Hattori, A. Successful treatment of diffuse large B-cell lymphoma with clarithromycin and prednisolone. Korean J Hematol, 2012;47;293-297.
    Pubmed
  4. Ohe, M, Hashino, S. Successful treatment with clarithromycin for Mixed phenotype acute leukemia, T/myeloid, NOS. Rinsho Ketsueki, 2010;51;297-299.
    Pubmed
  5. de Leval, L, Gisselbrecht, C, Gaulard, P. Advances in the understanding and management of angioimmunoblastic T-cell lymphoma. Br J Haematol, 2010;148;673-689.
    Pubmed
  6. Dogan, A, Ngu, LS, Ng, SH, Cervi, PL. Pathology and clinical features of angioimmunoblastic T-cell lymphoma after successful treatment with thalidomide. Leukemia, 2005;19;873-875.
    Pubmed
  7. Matsumura, Y, Kuroda, J, Shimura, Y, et al. Cyclosporine A and reduced-intensity conditioning allogeneic stem cell transplantation for relapsed angioimmunoblastic T cell lymphoma with hemophagocytic syndrome. Intern Med, 2012;51;2785-2787.
    Pubmed
  8. Ohe, M, Hashino, S. Successful treatment with erythromycin for idiopathic thrombocytopenic purpura. Korean J Hematol, 2011;46;139-142.
    Pubmed
  9. Wu, L, Zhang, W, Tian, L, Bao, K, Li, P, Lin, J. Immunomodulatory effects of erythromycin and its derivatives on human T-lymphocyte in vitro. Immunopharmacol Immunotoxicol, 2007;29;587-596.
    Pubmed
  10. Ratzinger, F, Haslacher, H, Poeppl, W, et al. Azithromycin suppresses CD4(+) T-cell activation by direct modulation of mTOR activity. Sci Rep, 2014;4;7438.
    Pubmed
  11. Hoeben, A, Landuyt, B, Highley, MS, Wildiers, H, Van Oosterom, AT, De Bruijn, EA. Vascular endothelial growth factor and angiogenesis. Pharmacol Rev, 2004;56;549-580.
    Pubmed
  12. Zhao, WL, Mourah, S, Mounier, N, et al. Vascular endothelial growth factor-A is expressed both on lymphoma cells and endothelial cells in angioimmunoblastic T-cell lymphoma and related to lymphoma progression. Lab Invest, 2004;84;1512-1519.
    Pubmed
  13. Aguiar Bujanda, D. Complete response of relapsed angioimmunoblastic T-cell lymphoma following therapy with bevacizumab. Ann Oncol, 2008;19;396-397.
    Pubmed
  14. Matsune, S, Sun, D, Ohori, J, et al. Inhibition of vascular endothelial growth factor by macrolides in cultured fibroblasts from nasal polyps. Laryngoscope, 2005;115;1953-1956.
    Pubmed
  15. Saad, AS, Shaheen, SM, Elhamamsy, MH, Badary, OA. An open-label randomized controlled phase II study of clarithromycin (CL) plus CVP in patients (pts) with previously untreated stage III/IV indolent non Hodgkin lymphoma (NHL). J Clin Oncol (ASCO Annual Meeting Abstracts), 2014;32;abst e19510.

Article

Letter to the Editor

Blood Res 2016; 51(2): 139-142

Published online June 23, 2016 https://doi.org/10.5045/br.2016.51.2.139

Copyright © The Korean Society of Hematology.

Successful treatment of angioimmunoblastic T-cell lymphoma with clarithromycin

Masashi Ohe1*, and Satoshi Hashino2

1Department of General Medicine, JCHO Hokkaido Hospital, Sapporo, Japan.

2Health Care Center, Hokkaido University, Sapporo, Japan.

Correspondence to: Masashi Ohe. Department of General Medicine, JCHO Hokkaido Hospital, 1-8-3-18 Nakanoshima, Toyohira-ku, Sapporo 062-8618, Japan. masshi@isis.ocn.ne.jp

Received: May 30, 2015; Accepted: July 25, 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

    Fig 1.

    Figure 1.

    Cervical computed tomography (CT) images. (A) Cervical CT reveals right cervical lymphadenopathy. (B) Cervical enhanced CT reveals considerable improvement in right cervical lymphadenopathy after 3 cycles of chemotherapy with tetrahydropyranyl doxorubicin (50 mg on day 1), cyclophosphamide (750 mg on day 1), vincristine (1.6 mg on day 1), and prednisolone (50 mg on days 1–5). (C) Cervical CT reveals complete resolution of the right cervical lymphadenopathy at 6 months after clarithromycin add-on therapy.

    Blood Research 2016; 51: 139-142https://doi.org/10.5045/br.2016.51.2.139

    Fig 2.

    Figure 2.

    Cervical histopathology and immunohistochemical images. (A) A right cervical lymph node biopsy specimen reveals effacement of the normal architecture with abundant pleomorphic cells and marked proliferation of arborizing high endothelial venules (hematoxylin and eosin stain, ×100). (B) Pleomorphic cells composed of lymphocytes, eosinophils, and atypical cells with intermediate-sized nuclei and clear cytoplasm are evident (hematoxylin and eosin stain, ×400). (C) Immunohistochemical examination shows CD3 positive staining in lymphocytes and atypical cells (×400). (D) A bone marrow aspiration smear reveals normal bone marrow (May-Giemsa stain, ×100).

    Blood Research 2016; 51: 139-142https://doi.org/10.5045/br.2016.51.2.139

    References

    1. Ishimatsu, Y, Mukae, H, Matsumoto, K, et al. Two cases with pulmonary mucosa-associated lymphoid tissue lymphoma successfully treated with clarithromycin. Chest, 2010;138;730-733.
      Pubmed
    2. Ohe, M, Hashino, S. A case of follicular B-cell lymphoma treated using clarithromycin. Korean J Hematol, 2011;46;203-206.
      Pubmed
    3. Ohe, M, Hashino, S, Hattori, A. Successful treatment of diffuse large B-cell lymphoma with clarithromycin and prednisolone. Korean J Hematol, 2012;47;293-297.
      Pubmed
    4. Ohe, M, Hashino, S. Successful treatment with clarithromycin for Mixed phenotype acute leukemia, T/myeloid, NOS. Rinsho Ketsueki, 2010;51;297-299.
      Pubmed
    5. de Leval, L, Gisselbrecht, C, Gaulard, P. Advances in the understanding and management of angioimmunoblastic T-cell lymphoma. Br J Haematol, 2010;148;673-689.
      Pubmed
    6. Dogan, A, Ngu, LS, Ng, SH, Cervi, PL. Pathology and clinical features of angioimmunoblastic T-cell lymphoma after successful treatment with thalidomide. Leukemia, 2005;19;873-875.
      Pubmed
    7. Matsumura, Y, Kuroda, J, Shimura, Y, et al. Cyclosporine A and reduced-intensity conditioning allogeneic stem cell transplantation for relapsed angioimmunoblastic T cell lymphoma with hemophagocytic syndrome. Intern Med, 2012;51;2785-2787.
      Pubmed
    8. Ohe, M, Hashino, S. Successful treatment with erythromycin for idiopathic thrombocytopenic purpura. Korean J Hematol, 2011;46;139-142.
      Pubmed
    9. Wu, L, Zhang, W, Tian, L, Bao, K, Li, P, Lin, J. Immunomodulatory effects of erythromycin and its derivatives on human T-lymphocyte in vitro. Immunopharmacol Immunotoxicol, 2007;29;587-596.
      Pubmed
    10. Ratzinger, F, Haslacher, H, Poeppl, W, et al. Azithromycin suppresses CD4(+) T-cell activation by direct modulation of mTOR activity. Sci Rep, 2014;4;7438.
      Pubmed
    11. Hoeben, A, Landuyt, B, Highley, MS, Wildiers, H, Van Oosterom, AT, De Bruijn, EA. Vascular endothelial growth factor and angiogenesis. Pharmacol Rev, 2004;56;549-580.
      Pubmed
    12. Zhao, WL, Mourah, S, Mounier, N, et al. Vascular endothelial growth factor-A is expressed both on lymphoma cells and endothelial cells in angioimmunoblastic T-cell lymphoma and related to lymphoma progression. Lab Invest, 2004;84;1512-1519.
      Pubmed
    13. Aguiar Bujanda, D. Complete response of relapsed angioimmunoblastic T-cell lymphoma following therapy with bevacizumab. Ann Oncol, 2008;19;396-397.
      Pubmed
    14. Matsune, S, Sun, D, Ohori, J, et al. Inhibition of vascular endothelial growth factor by macrolides in cultured fibroblasts from nasal polyps. Laryngoscope, 2005;115;1953-1956.
      Pubmed
    15. Saad, AS, Shaheen, SM, Elhamamsy, MH, Badary, OA. An open-label randomized controlled phase II study of clarithromycin (CL) plus CVP in patients (pts) with previously untreated stage III/IV indolent non Hodgkin lymphoma (NHL). J Clin Oncol (ASCO Annual Meeting Abstracts), 2014;32;abst e19510.
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