A case of follicular B-cell lymphoma treated using clarithromycin

Masashi Ohe; Satoshi Hashino

doi:10.5045/kjh.2011.46.3.203

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Case Report

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Korean J Hematol 2011; 46(3):

Published online September 30, 2011

https://doi.org/10.5045/kjh.2011.46.3.203

A case of follicular B-cell lymphoma treated using clarithromycin

Masashi Ohe^1*, and Satoshi Hashino²

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¹Department of General Medicine, Hokkaido Social Insurance Hospital, Sapporo, Japan.

²Department of Gastroenterology and Hematology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.

Correspondence to : Correspondence to Masashi Ohe, M.D., Ph.D. Department of General Medicine, Hokkaido Social Insurance Hospital, 1-8-3-18 Nakanoshima, Toyohira-ku, Sapporo 062-8618, Japan. Tel: +81-11-831-5151, Fax: +81-11-821-3851, masshi@isis.ocn.ne.jp

Received: July 28, 2011; Revised: August 18, 2011; Accepted: August 23, 2011

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

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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.

Keywords B-cell lymphoma, Macrolide, Clarithromycin, Apoptosis, bcl-2

Article

Case Report

Korean J Hematol 2011; 46(3): 203-206

Published online September 30, 2011 https://doi.org/10.5045/kjh.2011.46.3.203

A case of follicular B-cell lymphoma treated using clarithromycin

Masashi Ohe^1*, and Satoshi Hashino²

¹Department of General Medicine, Hokkaido Social Insurance Hospital, Sapporo, Japan.

²Department of Gastroenterology and Hematology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.

Correspondence to: Correspondence to Masashi Ohe, M.D., Ph.D. Department of General Medicine, Hokkaido Social Insurance Hospital, 1-8-3-18 Nakanoshima, Toyohira-ku, Sapporo 062-8618, Japan. Tel: +81-11-831-5151, Fax: +81-11-821-3851, masshi@isis.ocn.ne.jp

Received: July 28, 2011; Revised: August 18, 2011; Accepted: August 23, 2011

Abstract

Keywords: B-cell lymphoma, Macrolide, Clarithromycin, Apoptosis, bcl-2

Abstract

Fig 1.

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Figure 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.

Blood Research 2011; 46: 203-206https://doi.org/10.5045/kjh.2011.46.3.203

Fig 2.

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Figure 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).

Blood Research 2011; 46: 203-206https://doi.org/10.5045/kjh.2011.46.3.203

Fig 3.

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Figure 3.

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

Blood Research 2011; 46: 203-206https://doi.org/10.5045/kjh.2011.46.3.203