Rituximab plus Autologous Hemotopoietic Stem Cell Transplantation for The Treatment of CD5 Positive Diffuse Large B Cell Lymphoma with Autoimmune Hemolytic Anemia.
- Author:
Yi-Qun HUANG
1
;
Rui-Ji ZHENG
1
;
Rong-Juan WU
1
;
Xu-Dong MA
2
Author Information
- Publication Type:Journal Article
- MeSH: Anemia, Hemolytic, Autoimmune; therapy; Antibodies, Monoclonal, Murine-Derived; therapeutic use; Antineoplastic Combined Chemotherapy Protocols; therapeutic use; CD5 Antigens; metabolism; Cisplatin; therapeutic use; Cyclophosphamide; therapeutic use; Cytarabine; therapeutic use; Doxorubicin; therapeutic use; Etoposide; therapeutic use; Hematopoietic Stem Cell Transplantation; Humans; Lymphoma, Large B-Cell, Diffuse; therapy; Methylprednisolone; therapeutic use; Middle Aged; Prednisone; therapeutic use; Rituximab; therapeutic use; Sentinel Lymph Node Biopsy; Vincristine; therapeutic use
- From: Journal of Experimental Hematology 2016;24(3):722-726
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVETo summarize the clinical features and therapy experience of a case of CD5 positive diffuse large B cell lymphoma (CD5+ DLBCL) with autoimmune hemolytic anemia (AIHA).
METHODSA 49-years old patient was investigated. The routine blood examination, bone marrow smear, Coombs test, serological test, chest CT, abdominal MR and immunochemistry etc were performed for this patient; and therapeutic effects of the chemotherapy regimen consisting of rituximab plus autologous hematopoietic stem cell transplantation (auto-HSCT) were observed.
RESULTSThe cervical lymphnode biopsy confirmed CD5+ DLBCL; the severe anemia, reticulocyte increase, Coombs test positive, and erythroid hyperplasia in bone marrow all suggested the occurence of autoimmune hemolytic anemia (AIHA). After plasma exchange, immune suppression using methylprednisolone, blood transfusion, one course of chemotherapy with "R-CHOP-E", the symptoms of AIHA in patient disappeared. After a continuous treatment for 3 courses of "R-CHOP-E", the bone marrow infiltration appeared, which was assessed as "PD", then the treatment was changed to the "R-ESHAP" for 4 courses, the patient was reassessed as "CR". The patient subsequently underwent auto-HSCT, followed up for 6 months, patientis still "CR".
CONCLUSIONThe status of the CD5+ DLBCL patient with AIHA is severe, and the prognosis is poor. The curative effect of the chemotherapy regimen with rituximab plus auto-HSCT for this patien is well.
