Kirchner E M, Ebsen M, Kirchner J, Theegarten D, Voigtmann R
Abteilung für Hämatologie/Onkologie, Katholisches Marienhospital Herne, Universitätsklinik, Germany.
Ann Oncol. 2001 Aug;12(8):1169-71. doi: 10.1023/a:1011628322057.
We demonstrate the usefulness of immunotherapy with the CD20 antibody Rituximab in a case of transformation of Hodgkin's disease (HD) to high-grade non-Hodgkin's lymphoma (NHL).
A 45-year-old women suffering from lymphocyte predominant HD of paragranuloma type (stage IVb) since 1995 showed mediastinal relapse despite of 6 cycles of chemotherapy following the COPP/ABVD-protocol in 1998. Again complete remission could be achieved after escalated BEA-COPP II therapy in May 1998. Six months later chest radiograph and CT depicted pulmonary nodules. The non-typical resection of the lung revealed pulmonary involvement of a high-grade T-cell rich large B-cell lymphoma with 100% of the tumoral cells CD20 positive. Since the symptoms occurred shortly after the BEA-COPP-escalated protocol chemotherapy resistance had to be assumed. Because of this problems and supported by the refusal of a high-dose chemotherapy with stem-cell transplantation by the patient we decided to perform a mono-immunotherapy with the monoclonal CD20 antibody Rituximab. Today, 14 months later, the patient is still in complete remission including the absence of B symptoms.
Immunotherapy against CD20 positive cells in cases of sequential HD and NHL seems to be an effective therapy in chemotherapy resistant cases because of the suspected clonally relation of both diseases.
我们证明了使用CD20抗体利妥昔单抗进行免疫治疗在1例霍奇金淋巴瘤（HD）转化为高级别非霍奇金淋巴瘤（NHL）的病例中的有效性。
一名45岁女性自1995年起患有结节性淋巴细胞为主型HD（IVb期），尽管在1998年按照COPP/ABVD方案进行了6个周期的化疗，但仍出现纵隔复发。1998年5月在强化BEA-COPP II治疗后再次实现完全缓解。6个月后，胸部X线片和CT显示肺部有结节。肺部的非典型切除显示为高级别富含T细胞的大B细胞淋巴瘤肺受累，肿瘤细胞100% CD20阳性。由于症状在BEA-COPP强化方案化疗后不久出现，不得不推测存在化疗耐药。鉴于此问题且患者拒绝接受高剂量化疗及干细胞移植，我们决定使用单克隆CD20抗体利妥昔单抗进行单药免疫治疗。如今，14个月后，患者仍处于完全缓解状态，包括无B症状。
在HD和NHL相继发生的病例中，针对CD20阳性细胞的免疫治疗在化疗耐药病例中似乎是一种有效的治疗方法，因为怀疑这两种疾病存在克隆相关性。
