title: Dramatical improvement of chemoresistant bone lymphoma with rituximab.
abstract: Non-Hodgkin's lymphoma of the bone is a very rare disease that accounts for approximately 5% of all extranodal non-Hodgkin's lymphomas and for 7-10% of primary bone tumours. We report the case of a 28-year-old man who, in June 2001, presented with a right humerus showing painful destructive lesions with pathological fractures. Biopsy revealed diffuse, large B-cell non-Hodgkin's lymphoma expressing CD20. The patient received six cycles of conventional chemotherapeutic regimen, including cyclophosphamide, doxorubicin, vincristine and prednisone, and VP-16 (etoposide), ifosfamide and mitoxantrone. His arm pain worsened, and x-rays demonstrated progressive disease. He began a trial of rituximab, 750 mg/week, for 4 weeks. There was improvement in pain after the first infusion. Radiographic studies conducted 3 months after rituximab therapy showed marked improvement in his humerus disease. MRI showed a decrease of tumour volume with residual minor signal abnormalities of the bone marrow. He had no evidence of recurrent lymphoma 24 months later.
authors.affiliation: Rheumatology and Physical Rehabilitation Department, Military Hospital Mohammed V, Rabat, Morocco.
authors.forename: Lahsen
authors.initials: L
authors.lastname: Achemlal
authors.forename: Mohamed
authors.initials: M
authors.lastname: Mikdame
authors.forename: Abderrazak
authors.initials: A
authors.lastname: Nouijai
authors.forename: Ahmed
authors.initials: A
authors.lastname: Bezza
authors.forename: Abdellah
authors.initials: A
authors.lastname: El Maghraoui
mesh_terms: D000328:Adult; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001859:Bone Neoplasms / Q000175:diagnosis* / Q000473:pathology; D019008:Drug Resistance, Neoplasm; D006801:Humans; D006811:Humerus / Q000000981:diagnostic imaging / Q000473:pathology; D016393:Lymphoma, B-Cell / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D011859:Radiography; D012074:Remission Induction; D000069283:Rituximab; D016896:Treatment Outcome
chemical_list: D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents; D000069283:Rituximab