title: Successful rituximab-CHOP treatment of systemic lupus erythematosus associated with diffuse large B-cell non-Hodgkin lymphoma.
abstract: The authors discuss the case of a 76-year-old female patient who has been suffering from subacute cutaneous lupus erythematosus since 1983. In 1999 she was diagnosed with systemic lupus erythematosus (SLE) based on her symptoms of malar rash, polyarthritis, leukopenia, autoimmune hemolytic anemia and positive anti-DNA antibody test. For this she received methylprednisolone and cyclophosphamide. After 3 years of remission, symptoms of cutaneous vasculitis appeared in 2004, which transitionally responded to treatment with azathioprin and methylprednisolone. Her cutaneous symptoms, however, progressed quickly along with generalized lymphadenopathy, splenomegaly and thrombocytopenia. Immunohistological evaluation of the lymph node biopsy showed diffuse large B-cell lymphoma. She developed complete remission after treatment with six-cycle R-CHOP (rituximab, and reduced doses of cyclophosphamide, vincristin, adriablastin, methylprednisolone). SLE became inactive and her symptoms of vasculitis resolved. The authors are bringing attention to one of the possible late complications of systemic lupus, and also underscoring that treatment with rituximab (+CHOP) was beneficial not only for the lymphoma but the SLE as well.
authors: 3rd Department of Internal Medicine, University of Debrecen, Debrecen, Hungary. zsocogo@gmail.com
authors: Zs
authors: Z
authors: Simon
authors: T
authors: T
authors: Tarr
authors: Zs
authors: Z
authors: Ress
authors: L
authors: L
authors: Gergely
authors: E
authors: E
authors: Kiss
authors: A
authors: A
authors: Illes
mesh_terms: D000368:Aged; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D058846:Antibodies, Monoclonal, Murine-Derived; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003520:Cyclophosphamide / Q000627:therapeutic use; D004317:Doxorubicin / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000188:drug therapy*; D016403:Lymphoma, Large B-Cell, Diffuse / Q000150:complications*; D008228:Lymphoma, Non-Hodgkin / Q000150:complications*; D011241:Prednisone / Q000627:therapeutic use; D000069283:Rituximab; D016896:Treatment Outcome; D014750:Vincristine / Q000627:therapeutic use
chemical_list: D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D000069283:Rituximab; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone
references: Arthritis Rheum. 2003 Feb;48(2):455-9
references: 12571855
references: Rheumatology (Oxford). 2005 Feb;44(2):176-82
references: 15494350
references: N Engl J Med. 2002 Jan 24;346(4):235-42
references: 11807147
references: Orv Hetil. 2006 Nov 19;147(46):2229-33
references: 17396395
references: J Rheumatol Suppl. 2006 May;77:24-8
references: 16652442
references: Curr Opin Pharmacol. 2004 Aug;4(4):398-402
references: 15251135
references: J Clin Oncol. 2001 Jan 15;19(2):389-97
references: 11208830
references: Arthritis Rheum. 2005 Feb;52(2):501-13
references: 15693003
references: Blood. 2002 Feb 1;99(3):754-8
references: 11806974
references: Blood. 2004 Nov 1;104(9):2635-42
references: 15226177
references: Arch Intern Med. 2005 Nov 14;165(20):2337-44
references: 16287762
references: Nat Clin Pract Rheumatol. 2005 Nov;1(1):22-30
references: 16932624
references: Ann Oncol. 2003 Apr;14(4):520-35
references: 12649096
references: J Clin Oncol. 1998 Aug;16(8):2825-33
references: 9704735
references: Arthritis Rheum. 2005 May;52(5):1481-90
references: 15880596
references: Autoimmun Rev. 2006 Jan;5(1):18-24
references: 16338207
references: J Natl Cancer Inst. 2006 Jan 4;98(1):51-60
references: 16391371
references: Arthritis Res Ther. 2003;5(4):157-9
references: 12823844