Abstract:
A 54-year-old male patient, who presented with multiple lymphadenopathies, bilateral leg edema, and oscheohydrocele, was diagnosed with diffuse large B-cell lymphoma (DLBCL) stage IVB. His lymphadenopathies disappeared after six courses of R-CHOP therapy, which consist of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone); however, right hypopyon and partly remaining testicular soft tissue masses with fluorodeoxyglucose accumulation were observed. Lymphoma cell infiltration was observed in the aqueous humor of the right anterior chamber and testis, which indicates DLBCL progression. Hypopyon disappeared after the first course of intrathecal chemotherapy combined with R-HDMA therapy, which consists of rituximab and high-dose methotrexate/cytarabine, but recurred in the third course. The patient then underwent busulfan and thiotepa (BuTT) therapy followed by autologous peripheral blood stem cell transplantation (auto-PBSCT) after four courses of R-HDMA therapy. Hypopyon promptly disappeared after BuTT therapy and no hypopyon recurrence was observed 9 months after auto-PBSCT. Therefore, BuTT therapy is effective for hypopyon associated with refractory DLBCL.
摘要:
一名54岁的男性患者,患有多发性淋巴结病的人,双侧腿部水肿,和鞘膜积液,诊断为弥漫性大B细胞淋巴瘤(DLBCL)IVB期。他的淋巴结病经6个疗程的R-CHOP治疗后消失,由利妥昔单抗组成,环磷酰胺,阿霉素,长春新碱,和泼尼松龙);然而,观察到右垂体和部分保留的睾丸软组织肿块,并伴有氟脱氧葡萄糖积累。右前房和睾丸房水可见淋巴瘤细胞浸润,这表明DLBCL进展。鞘内化疗联合R-HDMA治疗第1个疗程后血吸虫消失,其中包括利妥昔单抗和大剂量甲氨蝶呤/阿糖胞苷,但在第三道菜中复发。然后,患者接受了白消安和噻替帕(BuTT)治疗,然后在四个疗程的R-HDMA治疗后进行自体外周血干细胞移植(auto-PBSCT)。BuTT治疗后宫内积血不足迅速消失,auto-PBSCT后9个月未观察到宫内积血不足复发。因此,BuTT治疗对难治性DLBCL相关的细胞分泌不足有效。