Successful treatment with rituximab in a patient with splenic marginal zone B-cell lymphoma accompanied by cold agglutinin disease

Nihon Ronen Igakkai zasshi. Japanese journal of geriatrics
Masako YasuyamaMariko Fujibayashi

Abstract

An 81-year-old man was admitted to our hospital due to dyspnea in July 2008. A physical examination revealed marked splenomegaly, and the results of laboratory tests were as follows: hemoglobin (Hb)=7.0 g/dL, Ret=6.4%, WBC=24,100/μL (Ly: 20,003/μL), indirect bilirubin=3.6 mg/dL, LDH=232 IU/L. The cold agglutinin titer was 1 : 8,192, and a direct antiglobulin test was positive. A PET scan showed abnormal accumulation in the spleen and bone marrow. A bone marrow aspirate examination and biopsy demonstrated diffuse involvement of abnormal lymphocytes that were found to be positive for CD20 and negative for CD5, CD10, and cyclin D1. The immunoglobulin genes were clonally rearranged. Based on these findings, splenic marginal zone B-cell lymphoma (SMZL) associated with cold agglutinin disease (CAD) was diagnosed. Because the patient refused splenectomy, he was treated with four cycles of rituximab therapy (375 mg/kg, once a week). The Hb level and lymphocyte count subsequently normalized and the splenomegaly resolved. One year later, he relapsed and was again treated with rituximab therapy with complete remission. CAD accompanied by SMZL is very rare. Rituximab may be chosen as an alternative and effective therapeutic option in patie...Continue Reading

References

Dec 16, 2000·The American Journal of Surgical Pathology·J P Duong Van HuyenJ Diebold
Jul 27, 2002·Clinical Lymphoma·Catherine ThieblemontBertrand Coiffier
Nov 26, 2002·Blood·Vito FrancoEmilio Iannitto
Mar 5, 2003·British Journal of Haematology·Nilima Parry-JonesDaniel Catovsky
May 22, 2007·Hematological Oncology·C KalpadakisM K Angelopoulou
Dec 2, 2010·Blood·Emilio Iannitto, Claudio Tripodo

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