[Successful salvage therapy with cladribine and rituximab for a patient with a relapsed Asian variant of intravascular large B-cell lymphoma]

• Abstract: The Asian variant of intravascular large B-cell lymphoma (AIVL) is a rare aggressive lymphoma characterized by various clinical symptoms, hemophagocytic syndrome and predominant growth within vessels. We present a 73-year-old man with relapsed AIVL who had been treated with six courses of CHOP regimen. A half year later, he presented with high fever, sweat, dementia and hepatosplenomegaly without lymphadenopathy. A bone marrow biopsy showed prominent hemophagocytosis and immunological staining disclosed an augmented intrasinusal pattern of atypical large lymphocytes characteristic of the CD20+ and CD5+ phenotypes. As salvage therapy, CND-R (rituximab, cladribine, mitoxantrone, dexamethasone) was performed, and the clinical symptoms immediately and dramatically improved. Subsequently, CND-R therapy was repeated every 4 weeks. No serious adverse events were observed with the exception of grade 4 neutropenia and grade 3 thrombocytopenia. After completion of the fifth course, a bone marrow biopsy pathologically confirmed complete remission, leading to termination of this therapy. The patient has remained in remission for more than 15 months. CND-R therapy, which is effective for indolent lymphoma, may be one of the candidates in salvage therapy for relapsed AIVL.
• Authors: Akane Tsujimura, Koichi Miyamura, Yachiyo Kuwatsuka, Yoshihiro Inamoto, Masahiro Tokunaga, Taku Oba, Seitaro Terakura, Ritsuro Suzuki, Masafumi Ito, Takuhei Murase, Yoshihisa Kodera (Affiliation: Department of Hematology, Japanese Red Cross Nagoya First Hospital.)
• Journal: [Rinshō ketsueki] The Japanese journal of clinical hematology (Rinsho Ketsueki) Vol. 47 Issue 10 Pg. 1387-92 (Oct 2006) ISSN: 0485-1439 [Print] Japan
• PMID: 17094579 (Publication Type: Case Reports, English Abstract, Journal Article)

Chemical References

• Antibodies, Monoclonal
• rituximab
• Cladribine

Topics

• Aged
• Antibodies, Monoclonal (administration & dosage)
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Cladribine (administration & dosage)
• Drug Administration Schedule
• Humans
• Lymphoma, B-Cell (classification, drug therapy)
• Male
• Recurrence
• Salvage Therapy
• Vascular Neoplasms (classification, drug therapy)