title: Successful treatment of non-Hodgkin lymphoma associated immune thrombocytopenia with involved field radiotherapy.
abstract: Immune thrombocytopenia complicates the course and impacts the outcome of non-Hodgkin lymphoma (NHL-ITP, non-Hodgkin lymphoma-immune thrombocytopenic purpura). The response to corticosteroids and/or intravenous immune globulins is usually short lasting, but NHL-ITP usually responds to anti-lymphoma chemotherapy. It is not clear if this success is due to the elimination of the lymphomatous tissue or to the immunosuppressor/immunomodulator effect of chemotherapy. Myelosuppressive anti-lymphoma chemotherapy carries the risk of severe thrombocytopenia that may not respond adequately to platelet transfusion support. We report on a patient with recurrent diffuse large B-cell lymphoma that coincided with immune thrombocytopenia. Both diseases completely responded to involved field radiation therapy. This supports the hypothesis that at least in some cases of NHL-ITP, the lymphomatous clone secretes the anti-platelet antibodies. This supports the therapeutic decision making for these patients.
authors.affiliation: Radiation Therapy Program, BC Cancer Agency - Vancouver Island Centre, Victoria, BC, Canada.
authors.forename: Tanya
authors.initials: T
authors.lastname: Berrang
authors.forename: Caroline
authors.initials: C
authors.lastname: Holloway
authors.forename: Jason
authors.initials: J
authors.lastname: Hart
authors.forename: Adrian
authors.initials: A
authors.lastname: Yee
authors.forename: Brian
authors.initials: B
authors.lastname: Berry
authors.forename: Rami
authors.initials: R
authors.lastname: Kotb
mesh_terms: D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D006801:Humans; D015182:Lymphatic Irradiation; D016403:Lymphoma, Large B-Cell, Diffuse / Q000150:complications* / Q000188:drug therapy / Q000532:radiotherapy; D008297:Male; D009305:Nasopharynx / Q000000981:diagnostic imaging / Q000473:pathology; D009333:Neck; D011241:Prednisone / Q000008:administration & dosage; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000209:etiology / Q000532:radiotherapy*; D012008:Recurrence; D012074:Remission Induction; D016879:Salvage Therapy; D014057:Tomography, X-Ray Computed; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone
keywords: immune thrombocytopenia; non-Hodgkin lymphoma; radiotherapy