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Is R-CHOP Therapy a Lymphoma Growth Factor?

Abstract : This article describes the first reported case of dramatic lymphocytosis flare after initiation of R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) therapy for an indolent lymphoma. The study patient exhibited a marginal zone lymphoma with mild nodal involvement but packed infiltration of the bone marrow. After initiation of RCHOP therapy, lymphocyte count increased from 329 to 707 x 10(9)/L at day 7. Patient exhibited grade III infusion-related side effect during rituximab therapy. Lymphocyte flare was not accompanied with other clinical manifestation such as lymph node enlargement. Because patient's bone marrow aspirate showed a packed infiltration, it was hypothesized that lymphocytosis flare was a link to lymphocyte release from bone marrow and lymphocyte demargination. This report highlights the necessity to be vigilant after initiation of RCHOP therapy for lymphoma when pathologist notified a pack infiltration of the bone marrow.
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Submitted on : Tuesday, February 7, 2017 - 4:00:11 PM
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Laure Farnault, Cédric Mercier, Yael Berda-Haddad, Gérard Sébahoun, Régis Costello. Is R-CHOP Therapy a Lymphoma Growth Factor?. American Journal of Therapeutics, Lippincott, Williams & Wilkins, 2016, 23 (1), pp.E295-E297. ⟨10.1097/01.mjt.0000434041.54749.3d⟩. ⟨hal-01460124⟩



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