演題詳細

ポスター / Poster

ポスター 21 (Poster 21) :LPD/免疫不全・高齢者

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日程
2013年10月11日(金)
時間
16:50 - 17:50
会場
ポスター会場 / Poster (ロイトン札幌 3F ロイトンホールABCD)
座長・司会
岡 芳弘 (Yoshihiro Oka):1
1:大阪大学大学院医学系研究科 呼吸器・免疫アレルギー内科学
 
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Clinical features and outcome of 9 immunodeficiency-associated lymphoproliferative disorders

演題番号 : PS-1-151

河野 徳明 (Noriaki Kawano):1、小野 伸之 (Nobuyuki Ono):1、栗山 拓郎 (Takuro Kuriyama):1、吉田 周郎 (Shuro Yoshida):1、山下 清 (Kiyoshi Yamashita):1、上田 章 (Akira Ueda):1

1:Department of Internal Medicine, Miyazaki Prefectural Miyazaki Hospital, Miyazaki, Japan.

 

[Objectives]Therefore immunodeficiency-associated lymphoproliferative disorders(ID-LPD) is a rare clinical entity characterized by the heterogeneous histological findings ranges from polymorphic to monomorphic proliferated abnormal lymphocytes, the standard treatment has not been established.[Methods]To elucidate the clinical features and treatment outcome of ID-LPD in RA patients, we retrospectively analyzed 9 patients in our hospital for the last 5 years.[Results]The diagnoses of 9 patients were DLBCL, LPD, and MALT lymphoma, in 5, 3, and 1, respectively. At initial diagnosis, 6 patients were progressive stage of RA, and half of them were performed by total knee arthroplasty. At the initial treatment for RA, MTX, low dose PSL, SASP, CSP and biologics(infliximab, etanercept, tocilizumab) treatment were administered in 8, 9, 1, and 1, 4 (2,1,1), respectively. After the development of ID-LPD, discontinuation of MTX led the patients to CR, PR, and SD in 4, 2, and 2, respectively. Subsequently, R-CHOP, rituximab, and radiation treatment were administered in 2, 2, and 1, respectively. Relapse was observed 2 out of 4 MTX withdrawal remission group, and subsequent rituximab combined treatments led to the 2nd CR. Consequently, all patients attained disease-free during the average 38 months follow-up time.[Conclusion]In our retrospective study, less intensive treatments consisting of discontinuation with MTX, and subsequent rituximab combined treatments accrording to the stage of RA and PS may be an efficient therapeutic strategy for ID-LPD.

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