Department of Internal Medicine, Nippon Koukan Hospital, Kanagawa, Japan.
Department of Hematology, Eiju General Hospital, Tokyo, Japan.
J Clin Exp Hematop. 2023 Mar 28;63(1):43-48. doi: 10.3960/jslrt.22041. Epub 2023 Mar 26.
We present the case of an 85-year-old male patient diagnosed with human herpesvirus 8 (HHV8)-negative effusion-based lymphoma (EBL) that developed from long-lasting pleural effusion (PE) induced by dasatinib treatment for chronic myeloid leukemia (CML). After the onset of this disorder, dasatinib treatment was discontinued and drainage was performed to regress the effusion. The major molecular response (MMR) was thus lost. The patient did not tolerate nilotinib treatment, but bosutinib was successful in restoring MMR. During these clinical courses, the patient suffered from a recurrence of EBL, which was treated with rituximab-based chemotherapy. The PE sample just before the 3 cycle of chemotherapy revealed the proliferation of CD57-positive T cells, along with the disappearance of lymphoma cells. Anti-tumor immunity may have been activated following the immunochemotherapy in the undisturbed immunological environment when both EBL and CML almost regressed. After four cycles of R-CVP therapy, the patient has been in remission for 16 months and no longer requires drainage.
我们报告了一例 85 岁男性患者的病例，该患者患有人类疱疹病毒 8 型（HHV8）阴性渗出性淋巴瘤（EBL），该病由达沙替尼治疗慢性髓性白血病（CML）引起的长期胸腔积液（PE）引起。该疾病发作后，停止了达沙替尼治疗并进行引流以消退积液。因此，主要分子反应（MMR）丧失。该患者不能耐受尼罗替尼治疗，但博舒替尼成功恢复了 MMR。在这些临床过程中，患者复发了 EBL，并接受了基于利妥昔单抗的化疗。在第 3 周期化疗前的胸腔积液样本中，发现 CD57 阳性 T 细胞增殖，同时淋巴瘤细胞消失。在 EBL 和 CML 几乎消退的未受干扰的免疫环境中，免疫化学疗法可能激活了抗肿瘤免疫。在接受 R-CVP 四周期治疗后，患者已缓解 16 个月，无需再进行引流。
