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Nat Clin Pract Oncol. 2006 Mar;3(3):165-8; quiz 169.

Sustained remission from angioimmunoblastic T-cell lymphoma induced by alemtuzumab.

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  • 1Yale University School of Medicine, New Haven, CT 06520-8021, USA.

Abstract

BACKGROUND:

A 73-year-old woman presented with acute lower back pain, fever, chills and arthralgias. She had previously had a positive protein derivative test with a negative chest X-ray; her medical history was also remarkable for a mitral valve prolapse. Initial symptoms resolved spontaneously without therapy, but fever recurred with associated arthralgias, myalgias, diffuse and worsening lymphadenopathy, splenomegaly, and bilateral pulmonary infiltrates.

INVESTIGATIONS:

Physical examination, blood and urine cultures, MRI of the spine, echocardiogram, extensive serologies, serum and urine protein electrophoresis, immunofixation electrophoresis, bone-marrow aspiration and biopsy with flow cytometry, cytogenetics, and gene rearrangement studies, CT scan of the chest, abdomen and pelvis, whole-body PET, and lymph-node biopsy for histological examination, immunohistochemistry, and gene rearrangement studies.

DIAGNOSIS:

Angioimmunoblastic T-cell lymphoma.

MANAGEMENT:

Steroids (prednisone, methylprednisolone), levofloxacin, isoniazid with pyridoxine, ciclosporin A, methotrexate, alemtuzumab, broad-spectrum antibiotics, Pneumocystis carinii prophylaxis, vancomycin, and clindamycin.

PMID:
16520806
[PubMed - indexed for MEDLINE]
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