Successful treatment of diffuse large B-cell lymphoma with clarithromycin and prednisolone

Masashi Ohe; Satoshi Hashino; Atsuo Hattori

doi:10.5045/kjh.2012.47.4.293

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Case Report

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Korean J Hematol 2012; 47(4):

Published online December 31, 2012

https://doi.org/10.5045/kjh.2012.47.4.293

Successful treatment of diffuse large B-cell lymphoma with clarithromycin and prednisolone

Masashi Ohe^1*, Satoshi Hashino³, and Atsuo Hattori²

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

²Department of Pathology, Hokkaido Social Insurance Hospital, Sapporo, Japan.

³Hokkaido 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: March 28, 2012; Revised: May 11, 2012; Accepted: October 9, 2012

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 diffuse large B-cell lymphoma (DLBCL) treated successfully with clarithromycin (CAM) and prednisolone (PSL). A 71-year-old woman presented with fever and cervical pain. DLBCL was diagnosed based on histological results from lymph node biopsy. Cervical pain was thought to be caused by the invasion of lymphoma cells into the cervical vertebrae. She initially received radiotherapy for the cervical lesion. She did not receive conventional chemotherapy because of the risk of recurrent non-tuberculous mycobacteria infection; therefore, she was treated with 20 mg/day PSL and 800 mg/day CAM to induce apoptosis in lymphoma cells. Complete remission was achieved after 6 months. The present findings suggest that CAM and PSL may be effective in some cases of DLBCL.

Keywords Diffuse large B-cell lymphoma, Clarithromycin, Prednisolone, Apoptosis

Article

Case Report

Korean J Hematol 2012; 47(4): 293-297

Published online December 31, 2012 https://doi.org/10.5045/kjh.2012.47.4.293

Successful treatment of diffuse large B-cell lymphoma with clarithromycin and prednisolone

Masashi Ohe^1*, Satoshi Hashino³, and Atsuo Hattori²

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

²Department of Pathology, Hokkaido Social Insurance Hospital, Sapporo, Japan.

³Hokkaido 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: March 28, 2012; Revised: May 11, 2012; Accepted: October 9, 2012

Abstract

Keywords: Diffuse large B-cell lymphoma, Clarithromycin, Prednisolone, Apoptosis

Abstract

Fig 1.

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Figure 1.

Computed tomography (CT). (A) Chest CT revealing left axillary lymphadenopathy at admission. (B) Chest CT revealing no left axillary lymphadenopathy 6 months after initiation of clarithromycin and prednisolone treatment.

Blood Research 2012; 47: 293-297https://doi.org/10.5045/kjh.2012.47.4.293

Fig 2.

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Figure 2.

Bone CT and bone scintigram. (A) Bone CT revealing bone destruction of the axis at admission. (B) Bone scintigram revealing abnormal uptake into vertebrae, sternum, ribs, left scapula, pelvis, and right femur at admission.

Blood Research 2012; 47: 293-297https://doi.org/10.5045/kjh.2012.47.4.293

Fig 3.

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Figure 3.

Fluorodeoxyglucose (FDG)-positron emission tomography (PET). (A) FDG-PET revealing increased spotty uptake into vertebrae, sternum, rib bones, pelvis, right femur, and bilateral axillary lymph nodes, and moderate serial uptake into the cervical to lumbar-region vertebrae at admission. (B) FDG-PET showing no abnormal uptake 6 months after initiation of clarithromycin and prednisolone treatment.

Blood Research 2012; 47: 293-297https://doi.org/10.5045/kjh.2012.47.4.293

Fig 4.

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Figure 4.

Histological and immunohistochemical examination of left axillary lymph node biopsy specimens. (A) Histological examination revealing proliferation of atypical large lymphocytes with pleomorphic, irregular nuclei and prominent nucleoli, accompanied by small lymphocytes (hematoxylin and eosin stain ×400). (B) Immunohistochemical examination for CD20 exhibiting positive staining in large lymphocytes (immunohistochemical stain ×400). (C) Immunohistochemical examination for bcl-2 exhibiting positive staining in large lymphocytes (immunohistochemical stain ×400). (D) Immunohistochemical examination for MIB-1 exhibiting positive staining in large lymphocytes (immunohistochemical stain ×400).

Blood Research 2012; 47: 293-297https://doi.org/10.5045/kjh.2012.47.4.293