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Open AccessCase Report
Cancers 2018, 10(9), 304; https://doi.org/10.3390/cancers10090304

Classic Hodgkin Lymphoproliferative Diseases Clonally Unrelated to B-Chronic Lymphocytic Leukemia Successfully Treated with Bendamustine Plus Rituximab

1
Department of Hematology and Rheumatology, Kindai University Hospital, Faculty of Medicine, 377-2 Ohno-Higashi, Osaka-Sayama, Osaka 589-8511, Japan
2
Departments of Pathology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1143, Japan
3
Department of Pathology, Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba-shi, Ibaraki 305-8575, Japan
*
Author to whom correspondence should be addressed.
Received: 7 August 2018 / Revised: 29 August 2018 / Accepted: 30 August 2018 / Published: 3 September 2018
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Abstract

A 62-year-old male was diagnosed with chronic lymphocytic leukemia (CLL) and treated with a fludarabine-containing regimen which maintained the disease in a partial response. Nine years after diagnosis, a rapidly growing systemic lymphadenopathy was observed, and a biopsy specimen revealed the presence of typical Hodgkin/Reed-Sternberg (HRS) cells, surrounded by T-lymphocytes and CLL cells. Sequencing analysis of the germline complementary determining region 3 (CDR3) region of the immunoglobulin heavy chain (IGH) gene showed that the Hodgkin/Reed-Sternberg cells were clonally unrelated to the preexisting CLL cells and the HRS cells were composed of five different clones, leading to the molecular diagnosis of de novo lymphocyte-rich classic Hodgkin lymphoproliferative diseases (LPDs) with small lymphocytic lymphoma (SLL). As the initial treatment was neither effective for classic Hodgkin LPDs nor for SLL, Bendamustine, Rituximab (BR) was started and complete remission was achieved, which has continued for more than one year so far. BR may be a good therapeutic option for both entities without causing hematological toxicity. View Full-Text
Keywords: lymphoproliferative diseases; Hodgkin lymphoma; chronic lymphocytic leukemia; clonality; Hodgkin/Reed-Sternberg cell; bendamustine lymphoproliferative diseases; Hodgkin lymphoma; chronic lymphocytic leukemia; clonality; Hodgkin/Reed-Sternberg cell; bendamustine
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).
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Rai, S.; Tanaka, H.; Fujimoto, K.; Kumode, T.; Inoue, H.; Taniguchi, Y.; Morita, Y.; Espinoza, J.L.; Tatsumi, Y.; Ashida, T.; Matsuoka, R.; Kikuti, Y.Y.; Nakamura, N.; Matsumura, I. Classic Hodgkin Lymphoproliferative Diseases Clonally Unrelated to B-Chronic Lymphocytic Leukemia Successfully Treated with Bendamustine Plus Rituximab. Cancers 2018, 10, 304.

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