A Case of Pure Red Cell Aplasia Complicated with Diffuse Large B Cell Lymphoma, T-Cell-Rich/Histiocyte-Rich Variant: Effectiveness of Rituximab and Implications for a Common Immunopathogenic Role of B Lymphocytes

Vol. 113, No. 3, 2005

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Case Report

A Case of Pure Red Cell Aplasia Complicated with Diffuse Large B Cell Lymphoma, T-Cell-Rich/Histiocyte-Rich Variant: Effectiveness of Rituximab and Implications for a Common Immunopathogenic Role of B Lymphocytes
Naoki Oyaizu^a, Yasuji Kozai^c, Hideki Kodo^c, Shinji Sunaga^d, Keiichi Iwabuchi^e, Masaaki Higashihara^f, Shigeo Mori^b

^aDepartment of Laboratory Medicine and
^bDepartment of Cancer Biology, Institute of Medical Science, University of Tokyo,
^cDepartment of Transfusion Medicine, Tokyo Metropolitan Fuchu Hospital,
^dDepartment of Internal Medicine, Odaira Memorial Tokyo Hitachi Hospital, Tokyo, and
^eDepartment of Pathology and
^fFourth Department of Internal Medicine, Kitasato University School of Medicine, Sagamihara, Japan

Address of Corresponding Author

Acta Haematol 2005;113:194-197 (DOI: 10.1159/000084450)

Key Words

B cell lymphoma
Pure red cell aplasia
Rituximab

Abstract

Diffuse large B cell lymphoma, T-cell-rich/histiocyte-rich variant (DLBL-TH), is characterized by the presence of neoplastic B cells set in a background containing numerous non-neoplastic T lymphocytes and histiocytes. We report here the case of a patient with DLBL-TH who developed overt pure red cell aplasia (PRCA) following chemotherapy and autologous peripheral blood stem cell transplantation. Posttransplantation bone marrow biopsies revealed the absence of erythroid precursors associated with lymphoid aggregates composed of B cells mixed with numerous T cells and histiocytes. Administration of rituximab has led to complete recovery of erythropoiesis, which was associated not only with B cell depletion but also with a marked reduction in bone marrow T cells and histiocytes. These observations strongly suggest the particular pathogenetic role of the patient's B cells in inducing PRCA and recruiting T cells and histiocytes in situ.

Author Contacts

Naoki Oyaizu, MD, PhD
Department of Laboratory Medicine, Research Hospital
Institute of Medical Science, University of Tokyo
4-6-1 Shirokanedai, Minato-ku, Tokyo, 108-8639 (Japan)
Tel. +81 3 5449 5516, Fax +81 3 5449 5447, E-Mail oyaizu@ims.u-tokyo.ac.jp

Article Information

Received: March 31, 2004
Accepted after revision: August 18, 2004
Number of Print Pages : 4
Number of Figures : 2, Number of Tables : 0, Number of References : 17

Medline Abstract (ID 15870490)

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