Classic Hodgkin Lymphoproliferative Diseases Clonally Unrelated to B-Chronic Lymphocytic Leukemia Successfully Treated with Bendamustine Plus Rituximab.
Classic Hodgkin Lymphoproliferative Diseases Clonally Unrelated to B-Chronic Lymphocytic Leukemia Successfully Treated with Bendamustine Plus Rituximab.
复制标题
经典的霍奇金淋巴增生性疾病与Bendamustine Plus Rituximab成功治疗了与B-智细胞性白血病无关的。
DOI：
10.3390/cancers10090304
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发表时间：
2018-09-03
期刊：
影响因子：
5.2
通讯作者：
Matsumura I
中科院分区：
文献类型：
--
作者：
Rai S;Tanaka H;Fujimoto K;Kumode T;Inoue H;Taniguchi Y;Morita Y;Espinoza JL;Tatsumi Y;Ashida T;Matsuoka R;Kikuti YY;Nakamura N;Matsumura I
一名 62 岁男性被诊断患有慢性淋巴细胞白血病 (CLL)，并接受含氟达拉滨的治疗方案进行治疗，使疾病保持部分缓解。诊断九年后，观察到快速生长的全身淋巴结肿大，活检标本显示存在典型的霍奇金/里德-斯滕伯格 (HRS) 细胞，周围环绕着 T 淋巴细胞和 CLL 细胞。对免疫球蛋白重链（IGH）基因种系互补决定区3（CDR3）区域的测序分析表明，Hodgkin/Reed-Sternberg细胞与先前存在的CLL细胞没有克隆相关性，并且HRS细胞由五个不同的克隆组成，从而实现了富含淋巴细胞的经典霍奇金淋巴细胞增殖性疾病（LPD）伴小淋巴细胞淋巴瘤的分子诊断（SLL）。由于初始治疗对经典霍奇金 LPD 和 SLL 均无效，因此开始使用苯达莫司汀、利妥昔单抗 (BR) 并获得完全缓解，迄今已持续一年多。 BR 可能是这两种实体的良好治疗选择，且不会引起血液学毒性。
A 62-year-old male was diagnosed with chronic lymphocytic leukemia (CLL) and treated with a fludarabine-containing regimen which maintained the disease in a partial response. Nine years after diagnosis, a rapidly growing systemic lymphadenopathy was observed, and a biopsy specimen revealed the presence of typical Hodgkin/Reed-Sternberg (HRS) cells, surrounded by T-lymphocytes and CLL cells. Sequencing analysis of the germline complementary determining region 3 (CDR3) region of the immunoglobulin heavy chain (IGH) gene showed that the Hodgkin/Reed-Sternberg cells were clonally unrelated to the preexisting CLL cells and the HRS cells were composed of five different clones, leading to the molecular diagnosis of de novo lymphocyte-rich classic Hodgkin lymphoproliferative diseases (LPDs) with small lymphocytic lymphoma (SLL). As the initial treatment was neither effective for classic Hodgkin LPDs nor for SLL, Bendamustine, Rituximab (BR) was started and complete remission was achieved, which has continued for more than one year so far. BR may be a good therapeutic option for both entities without causing hematological toxicity.
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