RESUMO
A 79-year-old female with acute promyelocytic leukemia (APL) presented with second hematological relapse. She had been treated previously with modified AIDA protocol as the front-line therapy and had achieved complete remission. During ATRA maintenance therapy, the first hematological relapse occurred and she was treated with arsenic trioxide (ATO), achieving the second complete remission. After four courses of consolidation therapy of ATO, the second hematological relapse occurred. At this time, except for a transient effect of tamibarotene, neither arsenic trioxide nor combination chemotherapy was effective. The patient was then treated with two courses of gemtuzumab ozogamicin (GO) and achieved the third complete remission. At present, she is maintaining molecular remission more than one year after GO treatment. GO is considered to be a promising agent for elderly patients with relapsed acute promyelocytic leukemia resistant to arsenic trioxide.
Assuntos
Aminoglicosídeos/administração & dosagem , Anticorpos Monoclonais/administração & dosagem , Antineoplásicos/administração & dosagem , Leucemia Promielocítica Aguda/tratamento farmacológico , Idoso , Anticorpos Monoclonais Humanizados , Esquema de Medicação , Feminino , Gemtuzumab , Humanos , Leucemia Promielocítica Aguda/genética , Recidiva , Indução de Remissão , Fatores de Tempo , Resultado do TratamentoRESUMO
A 76-year-old man presented with fever of unknown origin and renal dysfunction. Laboratory examination revealed anemia, thrombocytopenia, hypoalbuminemia, proteinuria, and elevations of C-reactive protein, lactic dehydrogenase, creatinine and ferritin. (18)F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) imaging showed FDG accumulation in the renal cortex and spleen. Based on the imaging study, renal biopsy was performed and histological diagnosis of intravascular large B-cell lymphoma (IVLBCL) was made. Renal impairment due to IVLBCL is uncommon and is often difficult to diagnose early. FDG-PET/CT may be a useful tool for the early diagnosis of IVLBCL.
Assuntos
Febre de Causa Desconhecida/etiologia , Linfoma Difuso de Grandes Células B/complicações , Linfoma Difuso de Grandes Células B/diagnóstico , Tomografia por Emissão de Pósitrons , Insuficiência Renal/etiologia , Tomografia Computadorizada por Raios X , Neoplasias Vasculares/complicações , Neoplasias Vasculares/diagnóstico , Idoso , Anticorpos Monoclonais/administração & dosagem , Anticorpos Monoclonais Murinos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Ciclofosfamida/administração & dosagem , Doxorrubicina/administração & dosagem , Doxorrubicina/análogos & derivados , Fluordesoxiglucose F18 , Humanos , Linfoma Difuso de Grandes Células B/tratamento farmacológico , Masculino , Prednisolona/administração & dosagem , Compostos Radiofarmacêuticos , Rituximab , Resultado do Tratamento , Neoplasias Vasculares/tratamento farmacológico , Vindesina/administração & dosagemRESUMO
A 38-year-old Japanese man with myelodysplastic syndrome (MDS), whose bone marrow smears demonstrated hypercellularity, was treated with oral cyclosporin A (CsA) therapy. During the course of this therapy, the numbers of peripheral blood and bone marrow blasts increased and the level of serum lactate dehydrogenase increased. After discontinuation of CsA treatment, all of these levels rapidly decreased. We consider that CsA might accelerate disease progression in certain MDS cases.
Assuntos
Anemia Refratária com Excesso de Blastos/tratamento farmacológico , Ciclosporina/uso terapêutico , Imunossupressores/uso terapêutico , Síndromes Mielodisplásicas/tratamento farmacológico , Adulto , Anemia Refratária com Excesso de Blastos/sangue , Povo Asiático , Contagem de Células Sanguíneas , Medula Óssea/patologia , Progressão da Doença , Feminino , Humanos , Japão , Síndromes Mielodisplásicas/sangue , Resultado do TratamentoRESUMO
We report a case of primary low-grade B-cell lymphoma of mucosa-associated lymphoid tissue (MALT)-type of the liver presenting as a solitary mass in a patient with hepatitis C virus infection. A 73-year-old male was referred to our hospital because of a solitary mass in the liver, which was identified by ultrasonography during a routine follow-up study for his hepatitis C virus carrier status. A fine-needle biopsy was performed and the mass was diagnosed as non-Hodgkin's lymphoma. A detailed investigation showed no evidence of lymphoma in other sites. Left lateral segmentectomy was performed. Histologic examination showed diffuse, monotonous infiltration of centrocyte-like cells that are CD 19(+), CD 20(+), sIgM-lambda(+), CD 3(-), CD 5(-), CD 10(-). The patient received no adjuvant chemotherapy and is alive and disease free 34 months after surgery.
Assuntos
Hepatite C/complicações , Neoplasias Hepáticas/diagnóstico , Linfoma de Zona Marginal Tipo Células B/diagnóstico , Idoso , Intervalo Livre de Doença , Humanos , Imunofenotipagem , Neoplasias Hepáticas/complicações , Neoplasias Hepáticas/cirurgia , Linfoma de Zona Marginal Tipo Células B/complicações , Masculino , Invasividade NeoplásicaRESUMO
A 32-year-old woman at 21 gestational weeks was admitted because of leukocytosis with DIC. She was diagnosed as having acute promyelocytic leukemia and treated with all-trans retinoic acid (70 mg/body) in combination with daunorubicin and cytosine arabinoside. She achieved complete remission, and continuously received a second treatment with daunorubicin and cytosine arabinoside. Cesarean section was performed, and a live male infant was born in the 30th week of pregnancy. The mother and baby have progressed excellently to date. In a such case, the choice of treatment and time of birth should be considered depending on the individual situation.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Leucemia Promielocítica Aguda/tratamento farmacológico , Complicações Hematológicas na Gravidez/tratamento farmacológico , Tretinoína/administração & dosagem , Adulto , Cesárea , Citarabina/administração & dosagem , Daunorrubicina/administração & dosagem , Feminino , Humanos , Recém-Nascido , Masculino , Gravidez , Resultado da Gravidez , Indução de RemissãoRESUMO
A 38-year-old Japanese man with severe aplastic anemia had invasive pulmonary aspergillosis as a complication. He was treated with amphotericin B for six weeks, but the aspergillosis did not improve. Then he experienced a fatal myocardial infarction. An autopsy revealed disseminated aspergillosis involving pericarditis and Aspergillus embolization to the coronary arteries. This led to the acute myocardial infarction. Cardiac aspergillosis is rare, but should be included within the differential diagnosis when chest pain of unknown origin occurs in an immunosuppressed patient.