Sustained remission from angioimmunoblastic T-cell lymphoma induced by alemtuzumab.

Abstract

BACKGROUND:

A 73-year-old woman presented with acute lower back pain, fever, chills and arthralgias. She had previously had a positive protein derivative test with a negative chest X-ray; her medical history was also remarkable for a mitral valve prolapse. Initial symptoms resolved spontaneously without therapy, but fever recurred with associated arthralgias, myalgias, diffuse and worsening lymphadenopathy, splenomegaly, and bilateral pulmonary infiltrates.

INVESTIGATIONS:

Physical examination, blood and urine cultures, MRI of the spine, echocardiogram, extensive serologies, serum and urine protein electrophoresis, immunofixation electrophoresis, bone-marrow aspiration and biopsy with flow cytometry, cytogenetics, and gene rearrangement studies, CT scan of the chest, abdomen and pelvis, whole-body PET, and lymph-node biopsy for histological examination, immunohistochemistry, and gene rearrangement studies.

DIAGNOSIS:

Angioimmunoblastic T-cell lymphoma.

MANAGEMENT:

Steroids (prednisone, methylprednisolone), levofloxacin, isoniazid with pyridoxine, ciclosporin A, methotrexate, alemtuzumab, broad-spectrum antibiotics, Pneumocystis carinii prophylaxis, vancomycin, and clindamycin.

• Authors: Stephanie Halene, Arthur Zieske, Nancy Berliner
• Journal: Nature clinical practice. Oncology (Nat Clin Pract Oncol) Vol. 3 Issue 3 Pg. 165-8; quiz 169 (Mar 2006) ISSN: 1743-4254 [Print] England
• PMID: 16520806 (Publication Type: Case Reports, Journal Article)

Chemical References

• Antibodies, Monoclonal
• Antibodies, Monoclonal, Humanized
• Antibodies, Neoplasm
• Antineoplastic Agents
• Alemtuzumab

Topics

• Aged
• Alemtuzumab
• Antibodies, Monoclonal (therapeutic use)
• Antibodies, Monoclonal, Humanized
• Antibodies, Neoplasm (therapeutic use)
• Antineoplastic Agents (therapeutic use)
• Female
• Humans
• Immunoblastic Lymphadenopathy (diagnosis, drug therapy, etiology, physiopathology)
• Lymphoma, T-Cell (complications, diagnosis, drug therapy, physiopathology)