Clinical manifestation of angioimmunoblastic T-cell lymphoma with exuberant plasmacytosis.
Angioimmunoblastic T-cell lymphoma (AITL) is a rare subtype of non-Hodgkin lymphoma characterized by aggressive symptoms and various abnormal laboratory test results. One of the rare immunologic abnormalities in AITL is exuberant polyclonal plasmacytosis, but its clinical significance has not been evaluated. This report concerns three AITL cases with exuberant polyclonal plasmacytosis and investigates its clinical impact by comparison with 12 patients without plasmacytosis. Our study found that the performance status (PS) of the former was significantly worse and their serum immunoglobulin levels were significantly higher. All other parameters, including B symptoms, various prognostic scores, blood cell counts other than plasmacyte, and serum levels of lactate dehydrogenase, C-reactive protein and soluble interleukin-2 receptor, showed no significant differences. More importantly, although the diagnosis of AITL with plasmacytosis was not straightforward in our series, outcomes of treatment with conventional chemotherapy or immunosuppressive therapy with cyclosporine A were favorable. To conclude, AITL should be considered a candidate underlying disease of exuberant polyclonal plasmacytosis. Provided a correct diagnosis is made early and is followed by adequate treatment, the prognosis for AITL with plasmacytosis may not be worse than that for those without plasmacytosis despite the severe exhaustion at first presentation.
Division of Hematology and Oncology, Department of Medicine, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan.
Hisao
H
Nagoshi
Junya
J
Kuroda
Tsutomu
T
Kobayashi
Saori
S
Maegawa
Yoshiaki
Y
Chinen
Miki
M
Kiyota
Ryuko
R
Nakayama
Shinsuke
S
Mizutani
Yuji
Y
Shimura
Mio
M
Yamamoto-Sugitani
Yosuke
Y
Matsumoto
Shigeo
S
Horiike
Masafumi
M
Taniwaki
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D016572:Cyclosporine / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007119:Immunoblastic Lymphadenopathy / Q000097:blood / Q000188:drug therapy / Q000276:immunology* / Q000473:pathology*; D007136:Immunoglobulins / Q000097:blood; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016399:Lymphoma, T-Cell / Q000097:blood / Q000188:drug therapy / Q000276:immunology* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D010950:Plasma Cells / Q000276:immunology / Q000473:pathology*; D011379:Prognosis
D007136:Immunoglobulins; D007166:Immunosuppressive Agents; D016572:Cyclosporine