Kaur Anahat, Abughanimeh Omar, Zafar Yousaf, Pluard Timothy
Internal Medicine, University of Missouri-Kansas City School of Medicine, Kansas City, USA.
Hematology and Oncology, Saint Luke's Hospital, Kansas City, USA.
Cureus. 2019 Jan 2;11(1):e3814. doi: 10.7759/cureus.3814.
Diffuse large B-cell lymphoma (DLBL) is an aggressive type of non-Hodgkin lymphoma (NHL). Renal involvement in NHL is not uncommon in advanced stages; however, it is rare to have kidneys affected early in the course of the disease. Usual chemotherapy regimen for DLBL is rituximab, cyclophosphamide, hydroxydaunorubicin, oncovin and prednisone (R-CHOP). This is a case of a 50-year-old female diagnosed with DLBL who presented with bilateral renal involvement at disease onset and also underwent complete remission after six cycles of dose-adjusted rituximab, etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin (DA-REPOCH). Limited data exist on outcomes of patients with DLBL and renal disease who are treated with high-intensity regimes such as DA-REPOCH. It would be worth looking further into outcomes of DLBL patients especially with renal involvement on DA-REPOCH. Multicenter trials are required to demonstrate which of the two chemotherapy regimens (R-CHOP vs. DA-REPOCH) have better progression-free survival in this particular subset of patients.
弥漫性大B细胞淋巴瘤（DLBL）是一种侵袭性非霍奇金淋巴瘤（NHL）。NHL累及肾脏在晚期并不罕见；然而，在疾病早期肾脏受累则较为罕见。DLBL的常用化疗方案是利妥昔单抗、环磷酰胺、羟基柔红霉素、长春新碱和泼尼松（R-CHOP）。本文报告一例50岁女性，诊断为DLBL，疾病初发时即出现双侧肾脏受累，在接受六个周期的剂量调整利妥昔单抗、依托泊苷、泼尼松、长春新碱、环磷酰胺、多柔比星（DA-REPOCH）化疗后实现完全缓解。关于接受DA-REPOCH等高强度方案治疗的DLBL合并肾脏疾病患者的预后数据有限。进一步研究DLBL患者尤其是合并肾脏受累患者接受DA-REPOCH治疗的预后很有必要。需要进行多中心试验来证明这两种化疗方案（R-CHOP与DA-REPOCH）中哪一种在这一特定患者亚组中具有更好的无进展生存期。
