RESUMEN
Primary effusion lymphoma (PEL) is a rare type of non-Hodgkin’s lymphoma arising from a B-cell lineage characterized by the formation of malignant effusion in body cavities without evidence of a detectable tumor. The effusion contains tumor cells universally infected with human herpesvirus 8 (HHV8), which is the critical factor differentiating PEL from HHV8-unrelated PEL-like lymphoma (PEL-LL). This report describes a 77-year-old male patient with pleural effusion and ascites, containing lymphoma cells expressing a B-cell phenotype, but without markers of HHV8 in immunocytochemical analysis. The patient was diagnosed with PEL-LL and treated with six cycles of rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP), which resulted in a complete remission. The patient is currently disease-free 15 months post-treatment. To the best of our knowledge, this is the first report on administration of R-CHOP in a PEL-LL patient in South Korea.
Asunto(s)
Anciano , Humanos , Masculino , Ascitis , Linfocitos B , Ciclofosfamida , Doxorrubicina , Herpesvirus Humano 8 , Corea (Geográfico) , Linfoma , Linfoma de Efusión Primaria , Fenotipo , Derrame Pleural , Prednisolona , Rituximab , VincristinaRESUMEN
Posttransplantation lymphoproliferative disorder (PTLD) is a potentially fatal complication of hematopoietic stem cell transplantation (HPSCT) that occurs relatively early after the transplantation. The occurrence of PTLD is usually associated with Epstein-Barr virus (EBV) infection in patients who are treated by aggressive immunosuppressive therapy. PTLD presents as diverse manifestations, ranging from reactive lymphoid hyperplasia to high grade malignant lymphoma. In the present work, we describe a case of PTLD that was successfully treated with R-CHOP (rituximab, cyclophosphamide, adriamycin, vincristine, and prednisolone) chemotherapy in a 21-year-old female who received HLA-matched sibling HPSCT for severe aplastic anemia. At 120 days after transplantation, she had symptoms of dysphagia and a foreign body sensation in the throat and was diagnosed as PTLD, diffuse large B cell lymphoma involving a tonsil, cervical lymph nodes, an adrenal gland, and the liver. Three courses of R-CHOP resulted in complete remission.
Asunto(s)
Femenino , Humanos , Adulto Joven , Glándulas Suprarrenales , Anemia Aplásica , Anticuerpos Monoclonales de Origen Murino , Protocolos de Quimioterapia Combinada Antineoplásica , Ciclofosfamida , Trastornos de Deglución , Doxorrubicina , Cuerpos Extraños , Trasplante de Células Madre Hematopoyéticas , Células Madre Hematopoyéticas , Herpesvirus Humano 4 , Hígado , Ganglios Linfáticos , Linfoma , Linfoma de Células B , Trastornos Linfoproliferativos , Tonsila Palatina , Faringe , Prednisona , Seudolinfoma , Sensación , Hermanos , Trasplante de Células Madre , Trasplantes , Vincristina , RituximabRESUMEN
Posttransplantation lymphoproliferative disorder (PTLD) is a potentially fatal complication of hematopoietic stem cell transplantation (HPSCT) that occurs relatively early after the transplantation. The occurrence of PTLD is usually associated with Epstein-Barr virus (EBV) infection in patients who are treated by aggressive immunosuppressive therapy. PTLD presents as diverse manifestations, ranging from reactive lymphoid hyperplasia to high grade malignant lymphoma. In the present work, we describe a case of PTLD that was successfully treated with R-CHOP (rituximab, cyclophosphamide, adriamycin, vincristine, and prednisolone) chemotherapy in a 21-year-old female who received HLA-matched sibling HPSCT for severe aplastic anemia. At 120 days after transplantation, she had symptoms of dysphagia and a foreign body sensation in the throat and was diagnosed as PTLD, diffuse large B cell lymphoma involving a tonsil, cervical lymph nodes, an adrenal gland, and the liver. Three courses of R-CHOP resulted in complete remission.
Asunto(s)
Femenino , Humanos , Adulto Joven , Glándulas Suprarrenales , Anemia Aplásica , Anticuerpos Monoclonales de Origen Murino , Protocolos de Quimioterapia Combinada Antineoplásica , Ciclofosfamida , Trastornos de Deglución , Doxorrubicina , Cuerpos Extraños , Trasplante de Células Madre Hematopoyéticas , Células Madre Hematopoyéticas , Herpesvirus Humano 4 , Hígado , Ganglios Linfáticos , Linfoma , Linfoma de Células B , Trastornos Linfoproliferativos , Tonsila Palatina , Faringe , Prednisona , Seudolinfoma , Sensación , Hermanos , Trasplante de Células Madre , Trasplantes , Vincristina , RituximabRESUMEN
The objective of the current study was to investigate the treatment outcomes for the use of cyclophosphamide, adriamycin, vincristine, and prednisolone (CHOP) chemotherapy in adult patients with hemophagocytic lymphohistiocytosis (HLH). Seventeen HLH patients older than 18 yr of age were treated with CHOP chemotherapy. A response evaluation was conducted for every two cycles of chemotherapy. With CHOP chemotherapy, complete response was achieved for 7/17 patients (41.2%), a partial response for 3/17 patients (17.6%), and the overall response rate was 58.8%. The median response duration (RD) was not reached and the 2-yr RD rate was 68.6%, with a median follow-up of 100 weeks. Median overall survival (OS) was 18 weeks (95% CI, 6-30 weeks) and the 2-yr OS rate was 43.9%. Reported grade 3 or 4 non-hematological toxicities were increased serum liver enzyme levels and stomatitis. Grade 3 or 4 hematological toxicities were leukopenia (50.8%), anemia (20%), and thrombocytopenia (33.9%). Neutropenic fever was observed in 21.6% of patients (14/65 cycles), and most of the cases were resolved with supportive care including treatment with broad-spectrum antibiotics. CHOP chemotherapy seems to be effective in adult HLH patients and the toxicities are manageable.