Transformation of Hodgkin's disease to high-grade B-cell lymphoma: remission after Rituximab monotherapy. |
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Authors: | E. M. Kirchner M. Ebsen J. Kirchner D. Theegarten R. Voigtmann |
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Affiliation: | (1) Abteilung für Hämatologie/Onkologie, Katholisches Marienhospital Herne, Universitätsklinik, Germany;(2) Institut für Pathologie, Ruhr-Universität Bochum, Germany;(3) Klinik für Radiologische Diagnostik und Nuklearmedizin, Katholisches Marienhospital Herne, Universitätsklinik, Germany |
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Abstract: | Purpose:We demonstrate the usefulness of immunotherapy with theCD20 antibody Rituximab in a case of transformation of Hodgkin s disease(HD) to high-grade non-Hodgkin s lymphoma (NHL).Case report:A 45-year-old women suffering from lymphocytepredominant HD of paragranuloma type (stage IVb) since 1995 showed mediastinalrelapse despite of 6 cycles of chemotherapy following the COPP/ABVD-protocolin 1998. Again complete remission could be achieved after escalated BEA-COPPII therapy in May 1998. Six months later chest radiograph and CT depictedpulmonary nodules. The non-typical resection of the lung revealed pulmonaryinvolvement of a high-grade T-cell rich large B-cell lymphoma with 100%of the tumoral cells CD20 positive. Since the symptoms occurred shortly afterthe BEA-COPP-escalated protocol chemotherapy resistance had to be assumed.Because of this problems and supported by the refusal of a high-dosechemotherapy with stem-cell transplantation by the patient we decided toperform a mono-immunotherapy with the monoclonal CD20 antibody Rituximab.Today, 14 months later, the patient is still in complete remission includingthe absence of B symptoms.Conclusions:Immunotherapy against CD20 positive cells in casesof sequential HD and NHL seems to be an effective therapy in chemotherapyresistant cases because of the suspected clonally relation of bothdiseases. |
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Keywords: | B-cell lymphoma CD20 antigen Hodgkin /content/vv52j756267311x2/xxlarge8217.gif" alt=" rsquo" align=" BASELINE" BORDER=" 0" >s disease lymphoma therapy transformation |
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