Uemura Yoshiki, Imai Toshi, Nakajim Takeshi, Urata Tomoyuki, Doi Hiroyuki
Department of Internal Medicine, Hematology, Kochi Health Sciences Center.
Nihon Kokyuki Gakkai Zasshi. 2010 Jan;48(1):28-32.
A 56-year-old man had an endoscopic examination for dysphagia in March 2007 which revealed tumors in the esophagus and stomach. Pathological examination of the esophagus biopsy specimens showed an unspecified peripheral T cell lymphoma. The esophagus tumor was tolerant to CHOP and EPOCH therapy. After an autologous peripheral blood stem cell transplantation, a complete response was observed in the patient. However, a lymphoma relapse was diagnosed in the lung in September 2008. The relapsed lung lymphoma was tolerant to EPOCH therapy. The refractory pulmonary peripheral T cell lymphoma was remarkably reduced by PEGS therapy. PEGS therapy is useful for relapsed peripheral T cell lymphoma cases that tolerated standard chemotherapy. An allogenic hematopoietic stem cell transplantation or new molecular target therapy might be finally selected for refractory peripheral T cell lymphoma. However, an allogenic transplantation has some severe complications. Furthermore we could not easily try phase I or II new molecular target drug treatment. We think that PEGS therapy is a useful treatment for refractory peripheral T cell lymphoma before allogenic transplantation or new molecular target drug treatment.
一名56岁男性于2007年3月因吞咽困难接受内镜检查,结果显示食管和胃有肿瘤。食管活检标本的病理检查显示为未特定的外周T细胞淋巴瘤。食管肿瘤对CHOP和EPOCH疗法耐受。自体外周血干细胞移植后,患者出现完全缓解。然而,2008年9月在肺部诊断出淋巴瘤复发。复发的肺部淋巴瘤对EPOCH疗法耐受。PEGS疗法使难治性肺外周T细胞淋巴瘤明显缩小。PEGS疗法对耐受标准化疗的复发性外周T细胞淋巴瘤病例有用。对于难治性外周T细胞淋巴瘤,最终可能会选择异基因造血干细胞移植或新的分子靶向治疗。然而,异基因移植有一些严重并发症。此外,我们不容易尝试I期或II期新分子靶向药物治疗。我们认为PEGS疗法是在异基因移植或新分子靶向药物治疗之前用于难治性外周T细胞淋巴瘤的一种有用治疗方法。