RESUMO
Diffuse large B-cell Lymphoma (DLBCL) secondary to a chronic severe Epstein-Barr virus (EBV) infection has not been previously described in a patient with trisomy 21. Here we report the case of a 14-year-old girl with trisomy 21 with impaired control of EBV and DLBCL. She was cured with dose-adapted chemotherapy and hematopoietic stem cell transplantation without severe treatment-related toxicity. We describe the first case of EBV-positive DLBCL in a patient with trisomy 21 and we propose a treatment modality for this rare entity.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Síndrome de Down/terapia , Infecções por Vírus Epstein-Barr/terapia , Transplante de Células-Tronco Hematopoéticas/métodos , Herpesvirus Humano 4/isolamento & purificação , Linfoma Difuso de Grandes Células B/terapia , Adolescente , Terapia Combinada , Síndrome de Down/complicações , Síndrome de Down/genética , Síndrome de Down/virologia , Infecções por Vírus Epstein-Barr/complicações , Infecções por Vírus Epstein-Barr/virologia , Feminino , Humanos , Linfoma Difuso de Grandes Células B/complicações , Linfoma Difuso de Grandes Células B/genética , Linfoma Difuso de Grandes Células B/virologia , PrognósticoRESUMO
The aim of this study was to assess life goal achievements in long-term survivors (LTS) receiving cranial radiotherapy (CRT) as central nervous system (CNS) prophylaxis for acute lymphoblastic leukemia (ALL) during childhood, compared to healthy individuals. Participants in this study were 141 LTS treated in our center from 1961 to 1990. Questionnaires were mailed to LTS. Analyses were stratified by age classes comparing LTS and a matched healthy population living in the same geographic area, as well as comparing patients treated with 24 Gy vs. 18 Gy CRT. Survivors reached the same educational level as controls. Significant differences were noted according to age and CRT dose. LTS had similar employment rates to those of controls, but lower marriage rates. Most respondents described their life positively, but as worse in the 24 Gy group. This study highlights the good life satisfaction of our LTS despite the long-term effects of the disease and its treatment.
