Back to Search
Start Over
Leukemic and meningeal relapse of CD5+ intravascular large B-cell lymphoma with down-modulation of CD20 after rituximab therapy.
- Source :
-
International journal of hematology [Int J Hematol] 2006 Jul; Vol. 84 (1), pp. 74-8. - Publication Year :
- 2006
-
Abstract
- Although CD20- relapses of B-cell lymphoma following rituximab therapy have increasingly been reported recently, coexistence of both the original and selected clones on relapse in a single patient have not been described. We experienced such a case with rare CD5+ intravascular lymphomatosis (IVL). A 46-year-old woman was admitted because of IVL complicated with cauda equina syndrome and pulmonary infarction. Complete remission was successfully achieved with multidrug chemotherapy in combination with rituximab. However, the disease recurred after 8 months with leukemic progression and meningeal involvement. The phenotype of the abnormal lymphocytes in the peripheral blood was fundamentally the same (CD20+CD5+CD10-CD19+CD23-sIglambda+) as that of the cells in the cerebrospinal fluid (CSF). However, CD20 expression was decreased remarkably compared with that in the CSF and that in the bone marrow before therapy. The targeting of CD20 molecules on the tumor cell surface by rituximab may have provided a selective pressure on lymphoma cells. The escape phenomenon of the lymphoma cells from rituximab was observed by simultaneously comparing the CD20 expression of cells in the peripheral blood and in a site of sanctuary from rituximab, the CSF.
- Subjects :
- Antibodies, Monoclonal administration & dosage
Antibodies, Monoclonal, Murine-Derived
Female
Gene Expression Regulation, Leukemic drug effects
Humans
Lymphocytes metabolism
Lymphocytes pathology
Lymphoma, B-Cell cerebrospinal fluid
Lymphoma, B-Cell pathology
Meningeal Neoplasms cerebrospinal fluid
Meningeal Neoplasms pathology
Middle Aged
Recurrence
Remission Induction
Rituximab
Antigens, CD20 cerebrospinal fluid
Antineoplastic Combined Chemotherapy Protocols administration & dosage
CD5 Antigens cerebrospinal fluid
Lymphoma, B-Cell prevention & control
Meningeal Neoplasms prevention & control
Tumor Escape drug effects
Subjects
Details
- Language :
- English
- ISSN :
- 0925-5710
- Volume :
- 84
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- International journal of hematology
- Publication Type :
- Academic Journal
- Accession number :
- 16867907
- Full Text :
- https://doi.org/10.1532/IJH97.06033