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慢性髓性白血病治疗期间发生的霍奇金淋巴瘤作为继发性肿瘤:病例报告及文献复习

Hodgkin Lymphoma as a Secondary Neoplasm During Therapy for Chronic Myeloid Leukaemia: Case Report and Review of the Literature.

作者信息

Paczkowska Edyta, Janowski Michał, Karpińska Katarzyna, Ryłów Małgorzata, Zdziarska Barbara, Poncyljusz Wojciech, Machaliński Bogusław

机构信息

Department of General Pathology, Pomeranian Medical University, Szczecin, Poland.

Department of Hematology with Bone Marrow Transplantation Unit, University Hospital No. 1 of Pomeranian Medical University, Szczecin, Poland.

出版信息

Onco Targets Ther. 2021 Apr 12;14:2497-2503. doi: 10.2147/OTT.S300320. eCollection 2021.

Abstract

INTRODUCTION

Incidences of chronic myeloid leukaemia (CML) after treatment of Hodgkin lymphoma (HL) are well described. Here, we report a case of secondary HL in a patient with CML treated with dasatinib as a third-line treatment.

PATIENT INFORMATION

A 64-year-old male was diagnosed with CML and initially treated with imatinib and then with nilotinib due to resistance. Finally, the patient experienced cardiovascular complications, and dasatinib was introduced. After 19 months of treatment, the patient experienced enlargement of lymph nodes that formed packs on the neck.

INTERVENTIONS

Based on histopathological examination of the lymph nodes, a diagnosis of classical Hodgkin lymphoma - mixed cellularity was established. The patient was successfully treated with 4 cycles of AVD (adriamycin, vinblastine, dacarbazine) chemotherapy.

OUTCOMES

Complete metabolic remission of Hodgkin lymphoma is currently sustained, and the molecular response to dasatinib at a reduced dose of 50 mg daily corresponds with a deep molecular response.

CONCLUSION

In this report, we demonstrate the efficacy and safety of the combination of dasatinib and AVD regimens in coexisting CML and HL. This case report emphasizes the importance of insightful evaluation and differential diagnosis in cases of lymphadenopathy during CML treatment.

摘要

引言

霍奇金淋巴瘤(HL)治疗后慢性髓性白血病(CML)的发病率已有充分描述。在此,我们报告1例接受达沙替尼作为三线治疗的CML患者发生继发性HL的病例。

患者信息

一名64岁男性被诊断为CML,最初接受伊马替尼治疗,因耐药随后接受尼罗替尼治疗。最终,患者出现心血管并发症,遂引入达沙替尼。治疗19个月后,患者颈部出现成簇肿大的淋巴结。

干预措施

根据淋巴结的组织病理学检查,确诊为经典型霍奇金淋巴瘤-混合细胞型。患者接受4周期AVD(阿霉素、长春花碱、达卡巴嗪)化疗,治疗成功。

结果

目前霍奇金淋巴瘤维持完全代谢缓解,每日剂量减至50 mg时对达沙替尼的分子反应相当于深度分子反应。

结论

在本报告中,我们证明了达沙替尼与AVD方案联合治疗CML合并HL的有效性和安全性。本病例报告强调了CML治疗期间对淋巴结病进行深入评估和鉴别诊断的重要性。

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