Sustained complete remission of a limited-stage blastic plasmacytoid dendritic cell neoplasm followed by a simultaneous combination of low-dose DeVIC therapy and radiation therapy: a case report and review of the literature.
The patient was a 74-year-old man who was found to have a cutaneous mass on his left shoulder in February 2012. Because the mass bled easily and was tending to grow, total resection of the cutaneous tumor, which measured approximately 5 cm x 3 cm, was performed in July. Histopathological examination revealed a tumor that extended from the dermis to the cutaneous adipose tissue, but no invasion of the epidermis was seen. The tumor cells were plasmacytoid cells ranging in size from small to intermediate, and there was no nuclear irregularity. They had a high nuclear-cytoplasmic ratio, and nucleoli were observed. The tumor cells were CD4-positive, CD56-positive, and CD123-positive, and they were AE1/AE3-negative, CD3-negative, CD20-negative, and myeloperoxidase-negative. (18)F-fluorodeoxyglucose positron emission tomography-computed tomography (FDG-PET/CT), a bone marrow examination, etc., were performed, but no lesions were detected at other sites. Based on the above findings a diagnosis of blastic plasmacytoid dendritic cell neoplasm (BPDCN), Stage IEA, was made. Because the patient had limited-stage BPDCN and was elderly, we treated him with a simultaneous combination of low-dose DeVIC (dexamethasone, VP16, ifosfamide, and carboplatin) therapy and local radiation therapy (LRT) and sustained a complete remission for approximately 1 year. Simultaneous combination of non-CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) chemotherapy and LRT appeared to be useful in the treatment of limited-stage BPDCN even in the elderly.
Department of Hematology, Juntendo University Urayasu Hospital Urayasu, Japan.
Kei-Ji
KJ
Sugimoto
Asami
A
Shimada
Nanae
N
Yamaguchi
Hidenori
H
Imai
Mutsumi
M
Wakabayashi
Yasunobu
Y
Sekiguchi
Hiroshi
H
Izumi
Yasunori
Y
Ota
Norio
N
Komatsu
Masaaki
M
Noguchi
D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000032:analysis; D001706:Biopsy; D016190:Carboplatin / Q000008:administration & dosage; D059186:Chemoradiotherapy, Adjuvant; D003713:Dendritic Cells / Q000737:chemistry / Q000187:drug effects* / Q000473:pathology / Q000528:radiation effects*; D003907:Dexamethasone / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage; D007150:Immunohistochemistry; D008297:Male; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D012074:Remission Induction; D012878:Skin Neoplasms / Q000737:chemistry / Q000473:pathology / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome; D051598:Whole Body Imaging
D014408:Biomarkers, Tumor; D005047:Etoposide; D003907:Dexamethasone; D016190:Carboplatin; D007069:Ifosfamide
Blastic plasmacytoid dendritic cell neoplasm; CD123; CD4; CD56; DeVIC; local radiation therapy