Successful treatment with autologous peripheral blood stem cell transplantation for acquired immunodeficiency syndrome (AIDS)-related malignant lymphoma.

Abstract

A 62-year-old man was diagnosed with human immunodeficiency virus (HIV) infection while suffering from recurrent herpes zoster infection. Laboratory examination revealed CD4(+) lymphocyte count 16 cells/mul and HIV loading 150,000 copies/ml at presentation. In addition, he had multiple lymph node swelling. Histologic diagnosis of a biopsied lymph node was diffuse, large, B cell-type malignant lymphoma. The karyotype of the lymphoma cells was t(8;14)(q24;q32), which was confirmed by G-banding and fluorescent in situ hybridization. Positron emission tomography (PET)-combined CT scanning revealed systemic extranodal tumors involving the gastrointestinal tract, pancreas, and bone marrow. The clinical stage of the lymphoma was IVB and the international prognosis index was categorized as high. Complete remission (CR) of the lymphoma was obtained after 2 courses of CHOP (cyclophosphamide, adriamycin, vincristine, prednisolone) chemotherapy and 4 subsequent courses of rituximab-combined CHOP (R-CHOP). Highly active antiretroviral therapy (HAART) was started at the initiation of CHOP. Because of the poor prognosis of AIDS-related lymphoma, he received autologous peripheral blood stem cell transplantation with the MEAM protocol (ranimustine, etoposide, cytarabine, melphalan) as a conditioning procedure without a severe infectious episode. He remains in CR 24 months after the transplantation.

• Authors: Yuya NAGAI, Minako MORI, Daichi INOUE, Takaharu KIMURA, Sonoko SHIMOJI, Katsuhiro TOGAMI, Sumie TABATA, Akiko MATSUSHITA, Kenichi NAGAI, Yukihiro Imai, Toshiro Takafuta, Takayuki Takahashi
• Journal: [Rinsho ketsueki] The Japanese journal of clinical hematology (Rinsho Ketsueki) Vol. 50 Issue 11 Pg. 1641-6 (Nov 2009) ISSN: 0485-1439 [Print] Japan
• PMID: 20009441 (Publication Type: Case Reports, Journal Article)

Chemical References

• Antibodies, Monoclonal
• Antibodies, Monoclonal, Murine-Derived
• Rituximab
• Vincristine
• Doxorubicin
• Cyclophosphamide
• Prednisolone

Topics

• Antibodies, Monoclonal (administration & dosage)
• Antibodies, Monoclonal, Murine-Derived
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Antiretroviral Therapy, Highly Active
• Combined Modality Therapy
• Cyclophosphamide
• Doxorubicin
• Humans
• Lymphoma, AIDS-Related (therapy)
• Lymphoma, Large B-Cell, Diffuse (therapy)
• Male
• Middle Aged
• Peripheral Blood Stem Cell Transplantation
• Prednisolone
• Remission Induction
• Rituximab
• Transplantation Conditioning
• Transplantation, Autologous
• Treatment Outcome
• Vincristine