Antineoplastics
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Reactions 927 - 9 Nov 2002 S Antineoplastics Sarcoidosis: 2 case reports Two men, aged 44 and 41 years, developed sarcoidosis following antineoplastic therapy for non-Hodgkin’s lymphoma. The 44-year-old man received 1 cycle of antineoplastic therapy comprising anti-CD20 monoclonal antibody, cyclophosphamide, doxorubicin, vincristine, prednisolone (CHOP) plus rituximab [dosages not stated] and 2 cycles of CHOP without anti-CD20. Two weeks later, he complained of dyspnoea and fatigue. His body temperature was 39°C and he had elevated levels of C-reactive protein, ACE and lysozyme. A chest x-ray and CT scans revealed a micronodular reticular infiltrate and bronchial lavage showed an increase in CD4+ activated T cells. He received clarithromycin and cotrimoxazole [trimethoprim/sulfamethoxazole] and his temperature normalised; dyspnoea and fatigue persisted for 4 weeks. He received 3 further cycles of antineoplastic therapy. Subsequent CT scans demonstrated marked resolution of the interstitial infiltrate and, after 12 months’ follow-up, he had not had any flare of his sarcoidosis. The 41-year-old man received 6 cycles of antineoplastic therapy comprising cyclophosphamide, doxorubicin, vincristine, etoposide and prednisolone (CHOEP), followed by carmustine, etoposide, doxorubicin and melphalan [BEAM; dosages not stated], with autologous stem cell support. Four months later he complained of arthralgias in his ankles, knees and fingers and he had an undulating fever reaching 39°C each morning. He had nodular erythematous lesions on his lower arms and legs, an elevated C-reactive protein level and a prolonged erythrocyte sedimentation rate. Blood counts revealed anaemia, leucocytosis, neutrophilia, lymphopenia and an increased sCD25 level. A chest CT scan showed enlarged mediastinal lymph nodes. Histological examination of his skin lesions revealed erythema nodosum with granulomatous granulocytic infiltrates and bone marrow histology revealed multiple epithelioid granulomas without necrosis. He received prednisone and his joint pain, arthritis, abnormal laboratory results and lymphadenopathy resolved within 1 month. At 6 months’ follow-up he had not had any recurrence of sarcoidosis. Kornacker M, et al. Occurrence of sarcoidosis subsequent to chemotherapy for non-Hodgkin’s lymphoma: report of two cases. Annals of Hematology 81: 103-105, Feb 2002 - Germany 807209250 1 Reactions 9 Nov 2002 No. 927 0114-9954/10/0927-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Transcript of Antineoplastics
Reactions 927 - 9 Nov 2002
SAntineoplastics
Sarcoidosis: 2 case reportsTwo men, aged 44 and 41 years, developed sarcoidosis
following antineoplastic therapy for non-Hodgkin’slymphoma.
The 44-year-old man received 1 cycle of antineoplastictherapy comprising anti-CD20 monoclonal antibody,cyclophosphamide, doxorubicin, vincristine, prednisolone(CHOP) plus rituximab [dosages not stated] and 2 cycles ofCHOP without anti-CD20. Two weeks later, he complained ofdyspnoea and fatigue. His body temperature was 39°C and hehad elevated levels of C-reactive protein, ACE and lysozyme. Achest x-ray and CT scans revealed a micronodular reticularinfiltrate and bronchial lavage showed an increase in CD4+activated T cells. He received clarithromycin andcotrimoxazole [trimethoprim/sulfamethoxazole] and histemperature normalised; dyspnoea and fatigue persisted for 4weeks. He received 3 further cycles of antineoplastic therapy.Subsequent CT scans demonstrated marked resolution of theinterstitial infiltrate and, after 12 months’ follow-up, he had nothad any flare of his sarcoidosis.
The 41-year-old man received 6 cycles of antineoplastictherapy comprising cyclophosphamide, doxorubicin,vincristine, etoposide and prednisolone (CHOEP), followed bycarmustine, etoposide, doxorubicin and melphalan [BEAM;dosages not stated], with autologous stem cell support. Fourmonths later he complained of arthralgias in his ankles, kneesand fingers and he had an undulating fever reaching 39°C eachmorning. He had nodular erythematous lesions on his lowerarms and legs, an elevated C-reactive protein level and aprolonged erythrocyte sedimentation rate. Blood countsrevealed anaemia, leucocytosis, neutrophilia, lymphopeniaand an increased sCD25 level. A chest CT scan showedenlarged mediastinal lymph nodes. Histological examinationof his skin lesions revealed erythema nodosum withgranulomatous granulocytic infiltrates and bone marrowhistology revealed multiple epithelioid granulomas withoutnecrosis. He received prednisone and his joint pain, arthritis,abnormal laboratory results and lymphadenopathy resolvedwithin 1 month. At 6 months’ follow-up he had not had anyrecurrence of sarcoidosis.Kornacker M, et al. Occurrence of sarcoidosis subsequent to chemotherapy fornon-Hodgkin’s lymphoma: report of two cases. Annals of Hematology 81:103-105, Feb 2002 - Germany 807209250
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Reactions 9 Nov 2002 No. 9270114-9954/10/0927-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
