Effective anti-viral therapy for hemophagocytic syndrome associated with B-cell lymphoma

Hiroshi Gomyo, Manabu Shimoyama, Kentaro Minagawa, Kimikazu Yakushijin, Norinaga Urahama, Atsuo Okamura, Katsuya Yamamoto, Mitsuhiro Ito, Kazuo Chihara, Toshimitsu Matsui

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

A rheumatoid arthritis (RA) patient treated with low-dose methotrexate (MTX) therapy suffered from hemophagocytic syndrome (HPS) associated with B-cell lymphoma (B-LAHS). Administration of acyclovir and intravenous immunoglobulin promptly resolved laboratory test abnormalities accompanied with HPS. Moreover, hemophagocytic histiocytes and lymphoma cells in the bone marrow disappeared without anti-cancer therapy. Two months after reintroduction of MTX for RA flare, lymphoma re-grew rapidly without bone marrow involvement and HPS. Two cycles of combination chemotherapy induced the lymphoma to a complete remission/unconfirmed (CRu), but then the chemotherapy was discontinued due to severe side effects. In this case, on the basis of RA and MTX induced immunosuppressive state, Epstein-Barr virus (EBV) infection was associated with the development of HPS and lymphoma. Anti-viral therapy alone was effective against HPS and lymphoma at initial presentation and improved her general condition. This case indicates that anti-cancer therapy should be preceded by anti-viral therapy and withdrawal of immunosuppressive therapy in patients under immunosuppressive therapy, as long as the clinical situation permits.

Original languageEnglish (US)
Pages (from-to)1807-1810
Number of pages4
JournalLeukemia and Lymphoma
Volume44
Issue number10
DOIs
StatePublished - Oct 1 2003

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Hemophagocytic Lymphohistiocytosis
B-Cell Lymphoma
Lymphoma
Immunosuppressive Agents
Methotrexate
Rheumatoid Arthritis
Therapeutics
Epstein-Barr Virus Infections
Histiocytes
Acyclovir
Intravenous Immunoglobulins
Combination Drug Therapy
Bone Marrow Cells
Neoplasms
Bone Marrow
Drug Therapy

All Science Journal Classification (ASJC) codes

  • Hematology
  • Oncology
  • Cancer Research

Cite this

Gomyo, H., Shimoyama, M., Minagawa, K., Yakushijin, K., Urahama, N., Okamura, A., ... Matsui, T. (2003). Effective anti-viral therapy for hemophagocytic syndrome associated with B-cell lymphoma. Leukemia and Lymphoma, 44(10), 1807-1810. https://doi.org/10.1080/1042819031000103926
Gomyo, Hiroshi ; Shimoyama, Manabu ; Minagawa, Kentaro ; Yakushijin, Kimikazu ; Urahama, Norinaga ; Okamura, Atsuo ; Yamamoto, Katsuya ; Ito, Mitsuhiro ; Chihara, Kazuo ; Matsui, Toshimitsu. / Effective anti-viral therapy for hemophagocytic syndrome associated with B-cell lymphoma. In: Leukemia and Lymphoma. 2003 ; Vol. 44, No. 10. pp. 1807-1810.
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Gomyo, H, Shimoyama, M, Minagawa, K, Yakushijin, K, Urahama, N, Okamura, A, Yamamoto, K, Ito, M, Chihara, K & Matsui, T 2003, 'Effective anti-viral therapy for hemophagocytic syndrome associated with B-cell lymphoma', Leukemia and Lymphoma, vol. 44, no. 10, pp. 1807-1810. https://doi.org/10.1080/1042819031000103926

Effective anti-viral therapy for hemophagocytic syndrome associated with B-cell lymphoma. / Gomyo, Hiroshi; Shimoyama, Manabu; Minagawa, Kentaro; Yakushijin, Kimikazu; Urahama, Norinaga; Okamura, Atsuo; Yamamoto, Katsuya; Ito, Mitsuhiro; Chihara, Kazuo; Matsui, Toshimitsu.

In: Leukemia and Lymphoma, Vol. 44, No. 10, 01.10.2003, p. 1807-1810.

Research output: Contribution to journalArticle

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AU - Gomyo, Hiroshi

AU - Shimoyama, Manabu

AU - Minagawa, Kentaro

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AU - Urahama, Norinaga

AU - Okamura, Atsuo

AU - Yamamoto, Katsuya

AU - Ito, Mitsuhiro

AU - Chihara, Kazuo

AU - Matsui, Toshimitsu

PY - 2003/10/1

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N2 - A rheumatoid arthritis (RA) patient treated with low-dose methotrexate (MTX) therapy suffered from hemophagocytic syndrome (HPS) associated with B-cell lymphoma (B-LAHS). Administration of acyclovir and intravenous immunoglobulin promptly resolved laboratory test abnormalities accompanied with HPS. Moreover, hemophagocytic histiocytes and lymphoma cells in the bone marrow disappeared without anti-cancer therapy. Two months after reintroduction of MTX for RA flare, lymphoma re-grew rapidly without bone marrow involvement and HPS. Two cycles of combination chemotherapy induced the lymphoma to a complete remission/unconfirmed (CRu), but then the chemotherapy was discontinued due to severe side effects. In this case, on the basis of RA and MTX induced immunosuppressive state, Epstein-Barr virus (EBV) infection was associated with the development of HPS and lymphoma. Anti-viral therapy alone was effective against HPS and lymphoma at initial presentation and improved her general condition. This case indicates that anti-cancer therapy should be preceded by anti-viral therapy and withdrawal of immunosuppressive therapy in patients under immunosuppressive therapy, as long as the clinical situation permits.

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