ベンダムスチン単剤療法中にサイトメガロウイルス抗原血症をきたした難治低悪性度B細胞性リンパ腫の3例  [in Japanese] Development of cytomegalovirus antigenemia in 3 patients with B cell lymphoma treated with bendamustine monotherapy  [in Japanese]

Access this Article

Author(s)

Abstract

Bendamustineは再発・難治低悪性度B細胞性リンパ腫およびマントル細胞リンパ腫に対して有用性を示す新規薬剤であり,rituximabとの併用により治療効果の改善が期待されている。Bendamustineを含む治療はCHOP療法と比較して重症感染の頻度が少ないとの報告が多いが,サイトメガロウイルス(CMV)感染を含む日和見感染の報告もみられる。今回,我々は,再発・難治の低悪性度B細胞性リンパ腫3例にBendamustine単剤療法を行い,3例にCMV抗原血症を認めた。いずれの症例も3コース目以降に認め,valgansiclovir投与にて改善した。Bendamustine単剤療法は再発・難治性低悪性度リンパ腫に対し,高い治療効果を発揮するが,CMV再活性化を引き起こすリスクがある。リスク因子は不明であるが,bendamustineを含む治療レジメンを行う場合は,十分注意する必要があると考えられる。

Bendamustine is one of the new key drugs for patients with indolent lymphoma. Bendamustine, together with rituximab, significantly improves the treatment outcomes of these patients. In addition, previous clinical studies have shown the complication rate of severe infection in bendamustine-containing regimens to be relatively low as compared to those of conventional chemotherapeutic regimens such as CHOP. However, some clinical case reports have raised the possibility that bendamustine may abrogate the immune responses of patients and trigger opportunistic infections including cytomegalovirus reactivation. Herein, we report three indolent lymphoma cases becoming positive on cytomegalovirus antigenemia assay during bendamustine monotherapy. All events occurred after more than three courses of treatment with bendamustine. One patient showed decreased CD4 positive T lymphocytes before the development of cytomegalovirus antigenemia. All three patients were successfully treated with valganciclovir. Although the precise risk is unknown, it should be noted that bendamustine can potentially cause reactivation of/infection with cytomegalovirus and physicians should pay attention to the possibility of this infection during treatment with bendamustine-containing regimens.

Journal

  • Rinsho Ketsueki

    Rinsho Ketsueki 55(2), 239-243, 2014

    The Japanese Society of Hematology

Codes

Page Top