Primary bone marrow diffuse large B‑cell lymphoma accompanying cold agglutinin disease: A case report with review of the literature

Yamashita,Tomoko; Ishida,Mitsuaki; Moro,Hiroko; Yumoto,Hirofumi; Uchibayashi,Sachiko; Yoshii,Miyuki; Nakanishi,Ryota; Okuno,Hiroko; Yoshida,Takashi; Okuno,Takafumi; Hodohara,Keiko; Okabe,Hidetoshi

doi:10.3892/ol.2013.1695

2014-January Volume 7 Issue 1

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2014-January Volume 7 Issue 1

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Case Report

Primary bone marrow diffuse large B‑cell lymphoma accompanying cold agglutinin disease: A case report with review of the literature

Authors:
- Tomoko Yamashita
- Mitsuaki Ishida
- Hiroko Moro
- Hirofumi Yumoto
- Sachiko Uchibayashi
- Miyuki Yoshii
- Ryota Nakanishi
- Hiroko Okuno
- Takashi Yoshida
- Takafumi Okuno
- Keiko Hodohara
- Hidetoshi Okabe
View Affiliations / Copyright

Affiliations: Department of Clinical Laboratory Medicine, Shiga University of Medical Science, Otsu, Shiga 520‑2192, Japan, Department of Hematology, Shiga University of Medical Science, Otsu, Shiga 520‑2192, Japan, Division of Blood Service Center, Shiga University of Medical Science, Otsu, Shiga 520‑2192, Japan
Pages: 79-81
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Published online on: November 21, 2013

https://doi.org/10.3892/ol.2013.1695
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Abstract

Cold agglutinin disease (CAD) is a well‑recognized complication of lymphoproliferative disorders. It has been previously recognized that cases of primary CAD frequently exhibit underlying malignant lymphoma in the bone marrow. Lymphoplasmacytic lymphoma is the most common subtype of malignant lymphoma; however, diffuse large B‑cell lymphoma (DLBCL) has also been documented, albeit extremely rare. The current report presents a case of primary bone marrow DLBCL accompanying CAD. A 76‑year‑old male presented with fever and fatigue. Laboratory tests revealed anemia and elevated bilirubin and cold agglutinins with a titer of 8,192 at 4˚C. Bone marrow biopsy demonstrated DLBCL and systemic surveillance failed to detect tumorous lesions or lymphadenopathy. Following R‑THP‑COP therapy, cold agglutinins titer was markedly decreased (by <4); however, malignant lymphoma relapsed and cold agglutinin levels increased again (4,096). This is the second documented case of primary bone marrow DLBCL accompanying CAD. Previously, malignant lymphoma exclusively involving the bone marrow, namely primary bone marrow lymphoma (PBML), has been recognized as a rare and aggressive subtype. The analyses of the present study revealed that the incidence of hemolytic anemia in primary bone marrow DLBCL may be high compared with conventional DLBCL. Therefore, additional analyses are required to clarify the clinicopathological features of PBML.

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1	Martinez A, Ponzoni M, Agostinelli C, et al: Primary bone marrow lymphoma: an uncommon extranodal presentation of aggressive non-Hodgkin lymphomas. Am J Surg Pathol. 36:296–304. 2012. View Article : Google Scholar
2	Berentsen S: How I manage cold agglutinin disease. Br J Haematol. 153:309–317. 2011. View Article : Google Scholar : PubMed/NCBI
3	Ulvestad E, Berentsen S, Bo K and Shammas FV: Clinical immunology of chronic cold agglutinin disease. Eur J Haematol. 63:259–266. 1999. View Article : Google Scholar
4	Hauswirth A, Skrabs C, Schützinger C, Gaiger A, Lechner K and Jäger U: Autoimmune hemolytic anemias, Evans’ syndromes, and pure red cell aplasia in non-Hodgkin lymphomas. Leuk Lymph. 48:1139–1149. 2007.
5	Váróczy L, Gergely L, Zeher M, Szegedi G and Illés A: Malignant lymphoma-associated autoimmune diseases-a descriptive epidemiological study. Rheumatol Int. 22:233–237. 2002.
6	Níáinle F, Hamnvik OP, Gulmann C, et al: Diffuse large B-cell lymphoma with isolated bone marrow involvement presenting with secondary cold agglutinin disease. Int J Lab Hematol. 30:444–445. 2008.PubMed/NCBI
7	Airaghi L, Greco I, Carrabba M, et al: Unusual presentation of large B cell lymphoma: a case report and review of the literature. Clin Lab Haem. 28:338–342. 2006. View Article : Google Scholar : PubMed/NCBI
8	Kubota Y: A case of primary pulmonary malignant lymphoma associated with autoimmune hemolytic anemia. Nihon Kokyuki Gakkai Zasshi. 44:453–457. 2006.(In Japanese).
9	Sumi M, Ichikawa N, Shimizu I, Yotsumoto M, Ueno M and Kobayashi H: Primary diffuse large B-cell lymphoma of the bone marrow complicated with autoimmune hemolytic anemia and erythroid hypoplasia. Rinsho Ketsueki. 48:571–575. 2007.(In Japanese).
10	Alvares CL, Matutes E, Scully MA, et al: Isolated bone marrow involvement in diffuse large B cell lymphoma: a report of three cases with review of morphological, immunophenotypic and cytogenetic findings. Leuk Lymphoma. 45:769–775. 2004. View Article : Google Scholar

Journals

International Journal of Molecular Medicine

International Journal of Oncology

Molecular Medicine Reports

Oncology Reports

Experimental and Therapeutic Medicine

Oncology Letters

Biomedical Reports

Molecular and Clinical Oncology

World Academy of Sciences Journal

International Journal of Functional Nutrition

International Journal of Epigenetics

Medicine International

Primary bone marrow diffuse large B‑cell lymphoma accompanying cold agglutinin disease: A case report with review of the literature

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Abstract

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