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Lossing of CD20 antigen expression and relapsing after rituximab treatment in precursor B-cell lymphoblastic lymphoma/leukemia:a case report and review of the literature
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- Author:
- No author available
- Journal Title:
- JOURNAL OF LEUKEMIA & LYMPHOMA
- Issue:
- 4
- DOI:
- 10.3760/cma.j.issn.1009-9921.2005.04.005
- Key Word:
- 美罗华;B细胞恶性肿瘤;CD20表达丧失
Abstract： 目的探讨B细胞恶性肿瘤美罗华(rituximab)治疗后复发伴CD20抗原表达丢失患者的生物学特性.方法报道1例前体B细胞淋巴母细胞淋巴瘤/白血病(precursor-B-LBL/ALL)患者美罗华联合化疗治疗后复发时CD20抗原表达丧失,并进行文献复习.结果 1例39岁男性前体B细胞淋巴母细胞淋巴瘤/白血病(pre-B-LBL/ALL)患者,初治时流式细胞(FCAS)检测瘤细胞表达CD19CD20,CD22和CD25,弱表达CD34,而CD10表达阴性;免疫组化染色CD20广泛阳性;核型为92,XXYY,der(15)t(1;15)(q11;q26)×2[15]/46,XY[5].经美罗华联合mBACOD诱导治疗2疗程后获得完全缓解(CR).巩固化疗4疗程后,予美罗华、大剂量环磷酰胺(CTX)联合重组人源化粒细胞集落刺激因子(rh-G-CSF)动员、采集及冷冻保存自体外周血干细胞(PBSCs).最后一疗程化疗4个月后患者复发,复发时流式细胞(FCAS)检测表达CD19CD10,CD22,CD38和CD13,高表达CD34,而CD20,CD23和FMC7均阴性,免疫组化染色偶见CD20阳性细胞;核型转变为46,XY.结论 B细胞恶性肿瘤美罗华治疗后复发患者应重新进行病理组织学、免疫表型和细胞/分子遗传学检测.
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