International Journal of Hematology

, Volume 75, Issue 2, pp 195–200 | Cite as

Successful Treatment of Nasal T-Cell Lymphoma With a Combination of Local Irradiation and High-Dose Chemotherapy

  • Takaomi Sanda
  • Shinsuke Iida
  • Masato Ito
  • Kazuya Tsuboi
  • Kazuhisa Miura
  • Shinsuke Harada
  • Hirokazu Komatsu
  • Atsushi Wakita
  • Hiroshi Inagaki
  • Ryuzo Ueda
Case Report

Abstract

Nasal natural killer (NK)/T-cell lymphoma is characterized by an aggressive clinical course and poor prognosis. The term “NK/T-cell” lymphoma includes both the NK-cell type and the T-cell type, which are classified by immunophenotyping and according to T-cell receptor (TCR) rearrangement. In addition, CD56+ T-cell lymphoma is defined as NK-like T-cell lymphoma. This report concerns a 54-year-old woman with nasal T-cell lymphoma. Its phenotype showed pure T-cell type with CD3+, CD56, and TCR+ accompanied by Epstein-Barr virus infection. Although the lesions were localized in the nasal mucosa and facial skin (stage IE), local irradiation could not achieve complete remission (CR). We then administered 5 courses of CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisolone) regimen followed by high-dose chemotherapy with an autologous peripheral blood stem cell transplantation. This therapy resulted in CR. Our results suggest that this lymphoma subtype may be cured by means of intensive treatment soon after diagnosis.

Key words

Nasal T-cell lymphoma Autologous peripheral blood stem cell transplantation Combined modality therapy Local irradiation 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Referencess

  1. 1.
    Cheung MM, Chan JK, Lau WH, et al. Primary non-Hodgkin’s lymphoma of the nose and nasopharynx: clinical features, tumor immunophenotype, and treatment outcome in 113 patients.J Clin Oncol. 1998;16:70–77.CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Chan JK, Sin VC, Wong KF, et al. Non-nasal lymphoma expressing the natural killer cell marker CD56: a clinicopathologic study of 49 cases of uncommon aggressive neoplasm.Blood. 1997;89:4501–4513.PubMedGoogle Scholar
  3. 3.
    Jaffe ES, Chan JK, Su IJ, et al. Report of the workshop on nasal and related extranodal angiocentric T/natural killer cell lymphomas: definitions, differential diagnosis, and epidemiology.Am J Surg Pathol. 1996;20:103–111.CrossRefPubMedGoogle Scholar
  4. 4.
    Shih LY, Linag DC. Non-Hodgkin’s lymphoma in Asia.Hematol Oncol Clin North Am. 1991;5:983–1001.CrossRefPubMedGoogle Scholar
  5. 5.
    Ho FCS, Todd D, Loke SL, et al. Clinico-pathological features of malignant lymphoma in 294 Hong Kong Chinese patients—a retrospective study covering an eight-year period.Int J Cancer. 1984;34:143–148.CrossRefPubMedGoogle Scholar
  6. 6.
    Liang R, Todd D, Chan TK, et al. Nasal lymphoma, a retrospective analysis of 60 cases.Cancer. 1990;66:2205–2209.CrossRefPubMedGoogle Scholar
  7. 7.
    Harabuchi Y, Yamanaka N, Kataura A, et al. Epstein-Barr virus in nasal T-cell lymphoma in patients with lethal midline granuloma.Lancet. 1990;335:128–130.CrossRefPubMedGoogle Scholar
  8. 8.
    Mishima K, Horiuchi K, Kojya S, et al. Epstein-Barr virus in patients with polymorphic reticulosis (lethal midline granuloma) from China and Japan.Cancer. 1994;73:3041–3046.CrossRefPubMedGoogle Scholar
  9. 9.
    O’Leary G, Kennedy SM. Association of Epstein-Barr virus with sinonasal angiocentric T cell lymphoma.J Clin Pathol. 1995;48:946–949.CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Suzumiya J, Takeshita M, Kimura N, et al. Expression of adult and fetal natural killer cell markers in sinonasal lymphoma.Blood. 1994;83:2255–2260.PubMedGoogle Scholar
  11. 11.
    Chiang AKS, Chan ACL, Srivastava G, et al. Nasal T/natural killer (NK)-cell lymphomas are derived from Epstein-Barr virusinfected cytotoxic lymphocytes of both NK- and T-cell lineage.Int J Cancer. 1997;73:332–338.CrossRefPubMedGoogle Scholar
  12. 12.
    Chiang AKS, Arivastava G, Lau PWF, et al. Differences in T-cell-receptor gene rearrangement and transcription in nasal lymphomas of natural killer and T-cell types: implications on cellularorigin.Hum Pathol. 1996;27:701–707.CrossRefPubMedGoogle Scholar
  13. 13.
    Macon WR, Williams ME, Greer JP, et al. Natural killer-like T-cell lymphomas: aggressive lymphomas of T-large granular lymphocytes.Blood. 1996;87:1474–1483.Google Scholar
  14. 14.
    Jaffe ES. Classification of natural killer (NK) cell and NK-like T-cell malignancies.Blood. 1996;87:1207–1210.Google Scholar
  15. 15.
    Miller TP, Dahlberg S, Cassady JR, et al. Chemotherapy alone compared with chemotherapy plus radiotherapy for localized intermediate- and high-grade non-Hodgkin’s lymphoma.N Engl J Med. 1998;339:21–26.CrossRefGoogle Scholar
  16. 16.
    Harris NL, Jaffe ES, Stein H, et al. A revised European-American classification of lymphoid neoplasms: a proposal from the International Lymphoma Study Group.Blood. 1994;84:1361–1392.Google Scholar
  17. 17.
    Harris NL, Jaffe ES, Diebold J, et al. World Health Organization classification of neoplastic diseases of the hematopoietic and lymphoid tissues: report of the Clinical Advisory Committee meeting—Airlie House, Virginia, November 1997.J Clin Oncol. 1999;17:3835–3849.CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Van Gorp J, De Bruin PC, Sie-Go DM, et al. Nasal T-cell lymphoma: a clinicopathological and immunophenotypic analysis of 13 cases.Histopathology. 1995;27:139–148.CrossRefGoogle Scholar
  19. 19.
    Harabuchi Y, Imai S, Wakashima J, et al. Nasal T-cell lymphoma causally associated with Epstein-Barr virus: clinicopathologic, phenotypic, and genotypic studies.Cancer. 1996;77:2137–2149.CrossRefGoogle Scholar
  20. 20.
    Kanavaros P, Lescs MC, Briere J, et al. Nasal T-cell lymphoma: a clinicopathologic entity associated with peculiar phenotype and with Epstein-Barr virus.Blood. 1993;81:2688–2695.PubMedGoogle Scholar
  21. 21.
    Arnulf B, Copie-Bergman C, Delfau-Larue MH, et al. Nonhep-atosplenic gammadelta T-cell lymphoma: a subset of cytotoxic lymphomas with mucosal or skin localization.Blood. 1998;91:1723–1731.PubMedGoogle Scholar
  22. 22.
    Kessinger A, Armitage JO, Smith DO, et al. High-dose therapy and autologous peripheral blood stem cell transplantation for patients with lymphoma.Blood. 1989;74:1260–1265.PubMedGoogle Scholar
  23. 23.
    Armitage JO. Autologous bone marrow transplantation for patient with aggressive non-Hodgkin’s lymphoma.Bone Marrow Transplant. 1992;10:62–63.PubMedGoogle Scholar
  24. 24.
    Nademanee A, Molina A, O’Donnell MR, et al. Results of highdose therapy and autologous bone marrow/stem cell transplantation during remission in poor-risk intermediate- and high-grade lymphoma: international index high and high-intermediate risk group.Blood. 1997;90:3844–3852.PubMedPubMedCentralGoogle Scholar
  25. 25.
    Liang R, Chen F, Lee CK, et al. Autologous bone marrow trans plantation for primary nasal T/NK cell lymphoma.Bone Marrow Transplant. 1997;19:91–93.CrossRefPubMedGoogle Scholar
  26. 26.
    Sasaki M, Matsue K, Takeuchi M, et al. Successful treatment of disseminated nasal NK/T-cell lymphoma using double autologous peripheral blood stem cell transplantation.Int J Hematol. 2000;71:75–78.PubMedGoogle Scholar
  27. 27.
    Liang R, Todd D, Chiu E, et al. Treatment outcome and prognostic factors for primary nasal lymphoma.J Clin Oncol. 1995;13:666–670.CrossRefPubMedPubMedCentralGoogle Scholar
  28. 28.
    Shying MM, Chan JO, Lau WHY, et al. Primary non-Hodgkin’s lymphoma of the nose and nasopharynx: clinical features, tumor immunophenotype, and treatment outcome in 113 patients.J Clin Oncol. 1998;16:70–77.CrossRefGoogle Scholar

Copyright information

© The Japanese Society of Hematology 2002

Authors and Affiliations

  • Takaomi Sanda
    • 1
  • Shinsuke Iida
    • 1
  • Masato Ito
    • 1
  • Kazuya Tsuboi
    • 1
  • Kazuhisa Miura
    • 1
  • Shinsuke Harada
    • 1
  • Hirokazu Komatsu
    • 1
  • Atsushi Wakita
    • 1
  • Hiroshi Inagaki
    • 2
  • Ryuzo Ueda
    • 1
  1. 1.Second Department of Internal MedicineNagoya City University Medical SchoolNagoyaJapan
  2. 2.Second Department of PathologyNagoya City University Medical SchoolNagoyaJapan

Personalised recommendations