Chronic benign CD8+ lymphoproliferation in a patient after rituximab treatment
Authors:
M. Osovská 1; A. Janíková 1; L. Křen 2; A. Marečková 3
Authors‘ workplace:
Interní hematoonkologická a onkologická klinika, FN Brno a LF MU, Brno
1; Ústav patologie, FN Brno a LF MU, Brno
2; Centrum molekulární biologie a genové terapie, FN Brno
3
Published in:
Transfuze Hematol. dnes,24, 2018, No. 1, p. 53-57.
Category:
Case Reports
Overview
Chronic benign CD8+ proliferation is a rare affection that can mimic a variety of other diseases. It clinically manifests as cytopenia or infiltration of lymph nodes, liver, kidneys, the bowel and other organs. CD8+ expansion can be clonal or non-clonal and generally occurs in patients with innate or acquired immunodeficiency (HIV+) or in patients on immunosuppressive treatment. It has also been detected in patients following rituximab (anti-CD 20 antibody) treatment. The diagnosis can be difficult a standard biopsy may not identify the problem at first sight. We describe the case of a patient with lymphoma in remission pre-treated with rituximab, who was suspected of systemic relapse of her lymphoma (lymphadenopathy, fever, liver enzymes elevation). Biopsy of an enlarged lymph node showed “reactive lymphadenitis”. Flow cytometry revealed a pathological population of CD8+ lymphocytes. The treatment, quite different from that of lymphoma relapse, consisted of corticosteroids and regular IVIG administration led to regression of all clinical and laboratory signs. As rituximab is used more and more frequently, we can expect an increased incidence of this entity.
key words:
chronic CD8+ lymphoproliferation – follicular lymphoma – maintenance rituximab therapy – adverse effects of rituximab
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Labels
Haematology Internal medicine Clinical oncologyArticle was published in
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