Immune pancytopenia after chemotherapy in a patient with diffuse large B-cell lymphoma

During treatment for malignant lymphoma, cytopenia can develop for several reasons. In the treatment of cytopenia, various possibilities should be considered because inadequate treatment causes exacerbation of cytopenia and can lead to fatal conditions, such as infection and bleeding. Herein, we des...

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Bibliographic Details
Published in:BMJ case reports 2016-09, Vol.2016, p.bcr2016216880
Main Authors: Nagashima, Kazuyo, Tanaka, Hiroaki, Nagai, Yurie, Sugita, Yasumasa
Format: Article
Language:English
Subjects:
Aged, 80 and over
Anti-Inflammatory Agents - therapeutic use
Antineoplastic Agents - administration & dosage
Antineoplastic Agents - adverse effects
Antineoplastic Combined Chemotherapy Protocols - administration & dosage
Antineoplastic Combined Chemotherapy Protocols - adverse effects
Asian Continental Ancestry Group
Bendamustine Hydrochloride - administration & dosage
Bendamustine Hydrochloride - adverse effects
Bone Marrow - pathology
Female
Humans
Japan
Japan - ethnology
Lymphoma, Large B-Cell, Diffuse - blood
Lymphoma, Large B-Cell, Diffuse - drug therapy
Lymphoma, Large B-Cell, Diffuse - pathology
Neoplasm Recurrence, Local
Other Asian
Pancytopenia - blood
Pancytopenia - chemically induced
Pancytopenia - drug therapy
Prednisolone - therapeutic use
Reminder of Important Clinical Lesson
Rituximab - administration & dosage
Rituximab - adverse effects
Treatment Outcome
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Summary:During treatment for malignant lymphoma, cytopenia can develop for several reasons. In the treatment of cytopenia, various possibilities should be considered because inadequate treatment causes exacerbation of cytopenia and can lead to fatal conditions, such as infection and bleeding. Herein, we describe immune pancytopenia 3 months after the last exposure to chemotherapy in a patient with diffuse large B-cell lymphoma (DLBCL). She suffered from severe pancytopenia after two courses of rituximab and bendamustine therapy for a second relapse of DLBCL. Immune pancytopenia was diagnosed with bone marrow tests and the presence of autoantibodies; it promptly resolved after initiation of prednisolone therapy. Clinicians should be aware of immune cytopenia and monitor for it carefully, even if patients have already finished chemotherapy treatment.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2016-216880