Partially successful treatment of a patient with chronic lymphocytic leukemia and Hodgkin's disease: case report and literature review.
Chronic lymphocytic leukemia (CLL) is rarely associated with Hodgkin's disease (HD). We report a case of nodular sclerosis HD in a patient previously diagnosed with CLL. Reed-Sternberg cells were CD15(+) and CD30(+). He was treated with dose-escalated CHOP and at relapse, mitoxantrone, vinblastine, and CCNU (MVC) with partial response to the former and complete response to the latter, although the patient died 15 months later. Data from 88 other similar cases published in the English language were analyzed. Based on the histological and clinical features at the time of transformation, these patients were divided into distinct categories for analysis. Prognosis was found to be poorer in patients with continued active CLL when compared with those with CLL in remission at the time of transformation to HD. It is suggested that these two presentations may derive from different pathogenic mechanisms.
Adiga
Giridhar U
GU
Department of Medicine, Our Lady of Mercy Medical Center, New York Medical College, Bronx 10467, USA.
Abebe
Lool
L
Wiernik
Peter H
PH
D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use; D001913:Bowen's Disease / Q000188:drug therapy; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D020031:Epstein-Barr Virus Infections / Q000453:epidemiology; D017809:Fatal Outcome; D005260:Female; D006689:Hodgkin Disease / Q000188:drug therapy* / Q000453:epidemiology; D006801:Humans; D016130:Immunophenotyping; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000188:drug therapy* / Q000453:epidemiology / Q000601:surgery; D008130:Lomustine / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D008942:Mitoxantrone / Q000008:administration & dosage; D009378:Neoplasms, Multiple Primary / Q000188:drug therapy* / Q000453:epidemiology; D014411:Neoplastic Stem Cells / Q000737:chemistry / Q000473:pathology; D011241:Prednisone / Q000008:administration & dosage; D011379:Prognosis; D016539:Reed-Sternberg Cells / Q000473:pathology; D012074:Remission Induction; D012878:Skin Neoplasms / Q000188:drug therapy; D013156:Splenectomy; D014412:Tumor Virus Infections / Q000453:epidemiology; D014740:Vidarabine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D014747:Vinblastine / Q000008:administration & dosage; D014750:Vincristine / Q000008:administration & dosage
D000964:Antimetabolites, Antineoplastic; D014750:Vincristine; D014747:Vinblastine; D008130:Lomustine; D004317:Doxorubicin; D003520:Cyclophosphamide; D008942:Mitoxantrone; D014740:Vidarabine; C024352:fludarabine; D011241:Prednisone