Document Detail


Lymphoproliferative disorders after immunosuppressive therapy for aplastic anemia: a case report and literature review.
MedLine Citation:
PMID:  19295190     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A 61-year-old Japanese man was referred to our hospital in 2002 due to severe pancytopenia. Bone marrow and peripheral blood findings indicated he had severe aplastic anemia (AA). A whole-body CT scan and Ga scintigraphy revealed no abnormal findings. Antithymocyte globulin and cyclosporine A (CyA) were administered and he got transfusion independently. In September 2004, he complained of abdominal fullness and a skin eruption in the lower abdomen. An abdominal CT revealed a spleen mass and lymphoadenopathy of the pancreas head. Splenectomy was done, and he was diagnosed with a diffuse large B cell lymphoma (DLBCL) of the spleen and skin. His karyotype was associated with t(14; 18). CyA was stopped, all lesions disappeared, and then his AA relapsed. In January 2007, antithymocyte globulin/CyA was readministered. In May 2007, he complained of acute swelling in his right thigh. A biopsy from the tumor revealed DLBCL. CyA was stopped again, yet the lymphoma did not regress. He was given R-CHOP (rituximab, cyclophosphamide, doxorubicin hydrochloride, vincristine, prednisolone), followed by 5 cycles of R-VP (rituximab, vincristine, prednisolone) and radiation therapy, resulting in a partial remission. We report DLBCL after immunosuppressive therapy for AA. Although this is a rare complication, it should be considered before beginning immunosuppressive therapy.
Authors:
Yuhko Suzuki; Nozomi Niitsu; Miyuki Hayama; Takuji Katayama; Ryuji Ishii; Manabu Osaka; Koji Miyazaki; Mikio Danbara; Ryouichi Horie; Tsutomu Yoshida; Naoya Nakamura; Masaaki Higashihara
Publication Detail:
Type:  Case Reports; Journal Article; Review     Date:  2009-03-18
Journal Detail:
Title:  Acta haematologica     Volume:  121     ISSN:  1421-9662     ISO Abbreviation:  Acta Haematol.     Publication Date:  2009  
Date Detail:
Created Date:  2009-04-17     Completed Date:  2009-05-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0141053     Medline TA:  Acta Haematol     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  21-6     Citation Subset:  IM    
Copyright Information:
(c) 2009 S. Karger AG, Basel.
Affiliation:
Department of Hematology, School of Medicine, Kitasato University, Sagamihara, Japan. ysuzuki-hki@umin.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Anemia, Aplastic / complications*,  pathology,  therapy
Antibodies, Monoclonal / administration & dosage
Antilymphocyte Serum / administration & dosage,  adverse effects
Antineoplastic Combined Chemotherapy Protocols / administration & dosage
Asian Continental Ancestry Group
Cyclophosphamide / administration & dosage
Cyclosporine / administration & dosage,  adverse effects
Doxorubicin / administration & dosage
Humans
Immunosuppression / adverse effects*
Immunosuppressive Agents / administration & dosage,  adverse effects
Japan
Lymphoma, Large B-Cell, Diffuse / etiology*,  pathology,  therapy
Male
Middle Aged
Prednisolone / administration & dosage
Radionuclide Imaging
Radiotherapy / methods
Skin Neoplasms / etiology*,  pathology,  therapy
Splenectomy
Splenic Neoplasms / etiology*,  pathology,  therapy
Tomography, X-Ray Computed
Vincristine / administration & dosage
Chemical
Reg. No./Substance:
0/Antibodies, Monoclonal; 0/Antilymphocyte Serum; 0/Immunosuppressive Agents; 0/rituximab; 23214-92-8/Doxorubicin; 50-18-0/Cyclophosphamide; 50-24-8/Prednisolone; 57-22-7/Vincristine; 59865-13-3/Cyclosporine

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