一名弥漫性大B细胞淋巴瘤患者化疗后出现免疫性全血细胞减少症。
Immune pancytopenia after chemotherapy in a patient with diffuse large B-cell lymphoma.
作者信息
Nagashima Kazuyo, Tanaka Hiroaki, Nagai Yurie, Sugita Yasumasa
机构信息
Department of Internal Medicine, Asahi General Hospital, Asahi, Chiba, Japan.
Department of Hematology, Asahi General Hospital, Asahi, Chiba, Japan.
出版信息
BMJ Case Rep. 2016 Sep 20;2016:bcr2016216880. doi: 10.1136/bcr-2016-216880.
During treatment for malignant lymphoma, cytopenia can develop for several reasons. In the treatment of cytopenia, various possibilities should be considered because inadequate treatment causes exacerbation of cytopenia and can lead to fatal conditions, such as infection and bleeding. Herein, we describe immune pancytopenia 3 months after the last exposure to chemotherapy in a patient with diffuse large B-cell lymphoma (DLBCL). She suffered from severe pancytopenia after two courses of rituximab and bendamustine therapy for a second relapse of DLBCL. Immune pancytopenia was diagnosed with bone marrow tests and the presence of autoantibodies; it promptly resolved after initiation of prednisolone therapy. Clinicians should be aware of immune cytopenia and monitor for it carefully, even if patients have already finished chemotherapy treatment.
在恶性淋巴瘤的治疗过程中，血细胞减少可能由多种原因引起。在治疗血细胞减少时，应考虑各种可能性，因为治疗不当会导致血细胞减少加重，并可能引发致命状况，如感染和出血。在此，我们描述了1例弥漫性大B细胞淋巴瘤（DLBCL）患者在最后一次接受化疗3个月后出现免疫性全血细胞减少的情况。她在接受两个疗程的利妥昔单抗和苯达莫司汀治疗后因DLBCL第二次复发而出现严重全血细胞减少。通过骨髓检查和自身抗体的存在诊断为免疫性全血细胞减少；泼尼松龙治疗开始后迅速缓解。临床医生应意识到免疫性血细胞减少并仔细监测，即使患者已经完成化疗。
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