A Clinico-Pathological Study to Investigate the Possible Infective Causes of Non-Hodgkin Lymphoma of the Ocular Adnexae

Patients with suspected lymphoma of the ocular adnexae will undergo a diagnostic biopsy in the usual way. If lymphoma is confirmed the patient will undergo a full staging evaluation and entry into either part A or B of the study will then be considered as follows:

• clinico-pathological (part A) for patients with MALT lymphoma of the ocular adnexae (MLOA) and eligible for treatment with Doxycycline 100 mg twice daily for 3 weeks ; or
• pathology only (part B) for patients with other types of ocular lymphoma, inflammatory lesions or those ineligible/unwilling for treatment with doxycycline.

Inclusion criteria

• Age 18 years or over
• Histologically confirmed marginal zone B-cell lymphoma of MALT-type
• Lymphoma localised to the ocular adnexae (conjunctiva, lacrimal gland, orbit soft tissue, clinical stage IEA) following a CT scan of neck, thorax, abdomen and pelvis, bone marrow aspirate/trephine, full blood count and biochemical profile
• No previous treatment, excepting RT for localised lymphoma of the contralateral eye
• At least one measurable lesion
• No systemic antibiotic therapy in the last three months
• No other malignancy in the previous 5 years apart from appropriately treated basal cell carcinoma of the skin or carcinoma in situ of the cervix
• In women with reproductive potential a willingness to use contraception from entry into the study for a period of 3 months
• Written informed consent

Exclusion criteria

• Pregnant or lactating women
• Known allergy to tetracycline
• Patients unwilling to comply with the requirements of follow-up as defined by this protocol
• Myasthenia gravis (tetracycline can exacerbate muscle weakness)
• Systemic lupus erythematous (tetracycline can exacerbate the condition)
• Patients with large or rapidly enlarging tumours requiring immediate radiotherapy