Systemic chemotherapy combined with thrombopoietin receptor agonist for the treatment of diffuse large B-cell lymphoma complicated with aplastic anemia

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  • FUKUDA Yasutaka
    Department of Hematology, Juntendo University Shizuoka Hospital Department of Hematology, Juntendo University School of Medicine
  • EDAHIRO Yoko
    Department of Hematology, Juntendo University School of Medicine
  • TAKAKU Tomoiku
    Department of Hematology, Juntendo University School of Medicine
  • FURUYA Chiho
    Department of Hematology, Juntendo University School of Medicine
  • SHIRANE Shuichi
    Department of Hematology, Juntendo University School of Medicine
  • HAMANO Yasuharu
    Department of Hematology, Juntendo University School of Medicine
  • KOIKE Michiaki
    Department of Hematology, Juntendo University Shizuoka Hospital
  • KOMATSU Norio
    Department of Hematology, Juntendo University School of Medicine

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Other Title
  • TPO受容体作動薬の併用により多剤併用化学療法を施行しえた再生不良性貧血合併悪性リンパ腫
  • TPO ジュヨウタイ サドウヤク ノ ヘイヨウ ニ ヨリ タザイ ヘイヨウ カガク リョウホウ オ シコウ シエタ サイセイ フリョウセイ ヒンケツ ガッペイ アクセイ リンパシュ

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Abstract

<p>Immunosuppressive therapies, including antithymocyte globulin and cyclosporine (CsA), are used for the treatment of aplastic anemia, but they reportedly cause lymphoproliferative diseases. Here, we report two cases of aplastic anemia in which diffuse large B-cell lymphoma developed during treatment with CsA. In both the cases, CsA was discontinued and combination therapy with R-CHOP (rituximab, cyclophosphamide, doxorubicin hydrochloride, vincristine sulfate, and prednisolone) plus the thrombopoietin receptor agonist eltrombopag was initiated. Furthermore, supportive care, including blood transfusion and granulocyte colony-stimulating factor, was provided. After six or eight courses of R-CHOP therapy, a complete metabolic response was achieved without serious adverse events. These cases illustrate the safety of combining R-CHOP with eltrombopag therapy in patients at a high risk of severe pancytopenia.</p>

Journal

  • Rinsho Ketsueki

    Rinsho Ketsueki 63 (1), 20-25, 2022

    The Japanese Society of Hematology

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