再発を繰り返しながら長期生存し得た濾泡性リンパ腫の2例

Abstract

【症例1】 69歳男性. 2006年濾胞性リンパ腫（ follicular lymphoma：FL）の診断となり，R-CHOP療法3コース実施したが再発，化学療法を経て自家末梢血幹細胞移植を実施するも再再発．その後サルベージ化学療法と再発を繰り返している．経過中視力の喪失や透析導入を経ながらも長期生存している．【症例2】 73歳男性. 2004年に胃癌に対する幽門側胃切除術時のリンパ節標本でFLの診断となった．R-CHOP療法3コース＋放射線療法を実施．RCOPE療法やBR療法を実施したが，C型肝炎による肝硬変で化学療法は困難となった．その後中枢神経浸潤による認知機能の低下や歩行障害を認めた．抗がん剤髄注により軽快したが2018年5月に病勢増悪のため死去．再発と治療を繰り返しながらも長期生存した濾胞性リンパ腫の2例を報告する．

Case 1：A 57 year-old man was diagnosed with follicullar lymphoma. He received three courses of rituximab,cyclophosphamide, dexorubicin, vincristine (sulfate) and prednisolone (R-CHOP) chemotherapy, but the lymphoma relapsed. He received autologous peripheral blood stem cell transplantation, but lymphoma relapsed again. He was treated with chemotherapy but the lymphoma repeatedly relapsed. Although he lost his sight because of lymphoma infiltration and introduced dialysis, lymphoma has maintained remission. Case2:A 59 year-old man was diagnosed with follicular lymphoma when he had an operation for gastric cancer. He received three courses of R-CHOP chemotherapy and radiation therapy. However, he showed relapse repeatedly. He received religious coping (R-COPE) and Bendamustine plus Rituximab (BR) chemotherapy. However, chemotherapy was discontinued because of his liver cirrhosis with hepatitis C. He was treated with intrathecal chemotherapy for central nerve invasion. He died of disease progression. Our two cases showed long-term survival in spite of repeateding relapse. Further improvement in prognosis of follicular lymphoma is expected.