Spontaneous Regression Of Adult T Cell Leukemia/lymphoma Following Development Of Immune Thrombocytopenia
Ureshino, H., & Miyahara, M. (2016). spontaneous regression of adult T cell leukemia/lymphoma following development of immune thrombocytopenia. Annals of hematology, 95(5), 841–843. https://doi.org/10.1007/s00277-016-2624-z
View Original Source →Case Details
Disease Location
Adult t-cell leukemia/lymphoma (atl)
Personal Characteristics
58 -year-old female previous diagnosed with acute-type atl
Clinical Characteristics
Admitted due to sudden onset of altered consciousness, hypercalcemia, and skin lesions after one course of combination therapy consisting of vcap, amp, and vecp lab work found an increase in wbc count, 23% of which consisted of atl cells, as well as decreased platelet count, and elevated serum calcium and soluble interleukin-2 receptor levels treatment was initiated with prednisolone and zoledronic acid, and vcap-amp was subsequently administered thrombocytopenia did not respond to platelet transfusion and the platelet count remained below 20k/ul. Platelet-associated immunoglobulin was positive bone marrow exam revealed the presence of megakaryocytes and increased cellularity without atl invasion the patient was diagnosed with immune thrombocytopenia (itp) itp persisted despite increased prednisolone and eltrombopag
Remission Characteristics
Disturbance in consciousness and hypercalcemia was improved with the treatment initiated, atl cells and skin erupatientions were gradually decreased complete remission was achieved with no additional chemotherapy after receiving vcap-amp she was thransferred for allogenic stem cell transplantation (sct) and after sct she remained in remission for 58 months. Platelet count increased 25 days after sct then returned to normal over 6 months
Treatment & Mechanisms
Proposed Remission Mechanisms
Assumpatiention of an undefined immunological mechanism the mechanism for atl remission involves t cell-mediated cytotoxicity, which plays a role in antitumor immune responses
Clinical Treatment
Underwent one course of combo therapy consisting of vcap (vincristine, cyclophosphamide, doxorubicin, and prednison), amp (doxorubicin, ranimustine, and prednisone), and vecp (vindesine, etoposide, carboplatin, and prednisone) treatment was initiated with prednisolone and zoledronic acid, and vcap-amp was subsequently administered eltrombopag allogenic stem cell transplantation
Non-Clinical Treatment
None reported