PDF(Pubmed)
Abstract：
BACKGROUND: Patients with autoimmune conditions receiving immunosuppressants are at risk of non-Hodgkin lymphomas (NHL). Vedolizumab (anti-α4β7-integrin antibody), a treatment-of-choice for Crohn\'s disease (CD), reduces inflammatory lymphocyte trafficking into the intestinal mucosa. This effect is believed to be confined to the colon.
METHODS: We report the case of a CD patient on vedolizumab for five years who developed pediatric-type follicular lymphoma. Work-up prior to therapy revealed a reduction in circulating T-lymphocytes and their suppressed response to mitogens. Rituximab, cyclophosphamide, vincristine, and prednisone chemo-immunotherapy resulted in durable lymphoma remission, and vedolizumab treatment was continued. While the patient\'s T-lymphocyte population and immunoglobulin production recovered, the T-lymphocyte mitogen response remained suppressed.
CONCLUSIONS: This patient\'s NHL may be linked to receiving anti-α4β7 therapy. Further research could be beneficial to determine if proactive surveillance for NHL and other systemic diseases is indicated in patients on vedolizumab.
METHODS: We report the case of a CD patient on vedolizumab for five years who developed pediatric-type follicular lymphoma. Work-up prior to therapy revealed a reduction in circulating T-lymphocytes and their suppressed response to mitogens. Rituximab, cyclophosphamide, vincristine, and prednisone chemo-immunotherapy resulted in durable lymphoma remission, and vedolizumab treatment was continued. While the patient\'s T-lymphocyte population and immunoglobulin production recovered, the T-lymphocyte mitogen response remained suppressed.
CONCLUSIONS: This patient\'s NHL may be linked to receiving anti-α4β7 therapy. Further research could be beneficial to determine if proactive surveillance for NHL and other systemic diseases is indicated in patients on vedolizumab.
摘要：
背景：接受免疫抑制剂的自身免疫性疾病患者有发生非霍奇金淋巴瘤（NHL）的风险。维多珠单抗（抗α4β7整合素抗体），克罗恩病（CD）的首选治疗方法，减少炎性淋巴细胞运输到肠粘膜。这种作用被认为局限于结肠。
方法：我们报告了一例使用维多珠单抗治疗5年的CD患者，其发展为小儿型滤泡性淋巴瘤。治疗前的检查显示，循环T淋巴细胞减少，对有丝分裂原的反应受到抑制。利妥昔单抗,环磷酰胺,长春新碱,和泼尼松化学免疫疗法导致持久的淋巴瘤缓解，维多珠单抗继续治疗.而患者的T淋巴细胞群和免疫球蛋白产生恢复，T淋巴细胞有丝分裂原反应仍然受到抑制。
结论：该患者的NHL可能与接受抗α4β7治疗有关。进一步的研究可能有助于确定是否在接受维多珠单抗治疗的患者中对NHL和其他全身性疾病进行主动监测。
方法：我们报告了一例使用维多珠单抗治疗5年的CD患者，其发展为小儿型滤泡性淋巴瘤。治疗前的检查显示，循环T淋巴细胞减少，对有丝分裂原的反应受到抑制。利妥昔单抗,环磷酰胺,长春新碱,和泼尼松化学免疫疗法导致持久的淋巴瘤缓解，维多珠单抗继续治疗.而患者的T淋巴细胞群和免疫球蛋白产生恢复，T淋巴细胞有丝分裂原反应仍然受到抑制。
结论：该患者的NHL可能与接受抗α4β7治疗有关。进一步的研究可能有助于确定是否在接受维多珠单抗治疗的患者中对NHL和其他全身性疾病进行主动监测。
