Effective high-dose chemotherapy followed by autologous peripheral blood stem cell transplantation in a patient with the aggressive form of cytophagic histiocytic panniculitis.
A 20-year-old Japanese man developed generalized, subcutaneous, painless nodules, fever, abnormal liver function, serosal effusions, hepatosplenomegaly, lymphadenopathy and anemia. Skin biopsies revealed lobular panniculitis with a morphologically benign histiocytic infiltration and prominent phagocytosis. Atypical T lymphocytes were also present in the skin and liver. The diagnosis given was aggressive cytophagic histiocytic panniculitis (CHP) or aggressive subcutaneous panniculitic T cell lymphoma (SPTCL). He received cyclophosphamide, doxorubicin, and vincristine on day 1, prednisolone on days 1-5, and etoposide on days 1, 3 and 5 (CHOP-E), with the support of granulocyte colony-stimulating factor. This regimen was repeated every 2 weeks and complete clinical remission (CCR) was attained after three cycles of CHOP-E. As the clinical course of aggressive CHP is recurrent and often fatal, he was given high-dose chemotherapy followed by autologous peripheral blood stem cell transplantation (APBSCT), after five cycles of CHOP-E. He has remained in CCR for 12 months after APBSCT. High-dose chemotherapy followed by APBSCT is considered to be one of the most beneficial therapies for patients with aggressive CHP and aggressive phase SPTCL.
Koizumi
K
K
Department of Internal Medicine II, Hokkaido University School of Medicine, Sapporo, Japan.
Sawada
K
K
Nishio
M
M
Katagiri
E
E
Fukae
J
J
Fukada
Y
Y
Tarumi
T
T
Notoya
A
A
Shimizu
T
T
Abe
R
R
Kobayashi
H
H
Koike
T
T
D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003520:Cyclophosphamide / Q000627:therapeutic use; D004317:Doxorubicin / Q000627:therapeutic use; D005047:Etoposide / Q000627:therapeutic use; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D016410:Lymphoma, T-Cell, Cutaneous / Q000145:classification / Q000175:diagnosis / Q000628:therapy*; D008297:Male; D010201:Panniculitis, Nodular Nonsuppurative / Q000145:classification / Q000175:diagnosis / Q000628:therapy*; D011241:Prednisone / Q000627:therapeutic use; D012074:Remission Induction / Q000379:methods; D009626:Terminology as Topic; D014750:Vincristine / Q000627:therapeutic use
D014750:Vincristine; D005047:Etoposide; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone