Benefit of prednisolone alone in nodal peripheral T-cell lymphoma with T follicular helper phenotype

DOI 機関リポジトリ Web Site 参考文献25件
  • Kitamura Wataru
    Department of Hematology, National Hospital Organization Iwakuni Clinical Center, Iwakuni, Japan, Department of Hematology, Oncology, and Respiratory Medicine, Okayama University Medical School, Okayama, Japan,
  • Kobayashi Hiroki
    Department of Hematology, Oncology, and Respiratory Medicine, Okayama University Medical School, Okayama, Japan,
  • Urata Tomohiro
    Department of Hematology, National Hospital Organization Iwakuni Clinical Center, Iwakuni, Japan, Department of Hematology, Oncology, and Respiratory Medicine, Okayama University Medical School, Okayama, Japan,
  • Sato Yumiko
    Department of Pathology, National Hospital Organization Iwakuni Clinical Center, Iwakuni, Japan,
  • Naoi Yusuke
    Department of Pathology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan,
  • Yoshino Tadashi
    Department of Pathology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan,
  • Maeda Yoshinobu
    Department of Hematology, Oncology, and Respiratory Medicine, Okayama University Medical School, Okayama, Japan,
  • Kuyama Shoichi
    Department of Respiratory Medicine, National Hospital Organization Iwakuni Clinical Center, Iwakuni, Japan

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<p>A 71-year-old Japanese man presented with severe thrombocytopenia. A whole-body CT at presentation showed small cervical, axillary, and para-aortic lymphadenopathy, leading to suspicion of immune thrombocytopenia due to lymphoma. Biopsy was difficult to perform because of severe thrombocytopenia. Thus, he received prednisolone (PSL) therapy and his platelet count gradually recovered. Two and a half years after PSL therapy initiation, his cervical lymphadenopathy slightly progressed without other clinical symptoms. Hence, a biopsy from the left cervical lymph node was performed, and he was diagnosed with nodal peripheral T-cell lymphoma (PTCL) with T follicular helper (TFH) phenotype. Due to various complications, we continued treatment with prednisolone alone after the diagnosis of lymphoma; however, there was no further increase in lymph node enlargement and no other lymphoma-related symptoms for one and a half years after diagnosis. Although immunosuppressive therapy has been reported to produce a response in some patients with angioimmunoblastic T-cell lymphoma, our experience suggests that a similar subset may exist in patients with nodal PTCL with TFH phenotype, which has the same cellular origin. Immunosuppressive therapies may constitute an alternative treatment option even in the era of novel molecular-targeted therapies, especially for elderly patients who are ineligible for chemotherapy.</p>

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