A case of clonally distinct relapse of Burkitt lymphoma 9 years after complete remission

Int J Hematol. 2015 May;101(5):520-4. doi: 10.1007/s12185-014-1729-1. Epub 2015 Jan 3.

Abstract

We report a case of HIV-negative Burkitt lymphoma (BL) that relapsed 9 years after complete remission. We performed a polymerase chain reaction analysis of three regions of the VDJ junction of the immunoglobulin heavy chain (IGH) gene and compared the clonality of the first and second BL lesions, which were found to be clonally distinct. The patient received the R-Hyper CVAD/R-MA regimen; however, leukoencephalopathy subsequently developed due to the effect of cytarabine, and the regimen was changed to R-IVAM. The patient achieved complete remission and received high-dose chemotherapy following autologous stem cell transplantation. He maintained the complete remission for 72 months after transplantation. Given this outcome, we suggest that clonally distinct relapse of HIV-negative BL may exhibit a good prognosis.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Base Sequence
  • Burkitt Lymphoma / genetics*
  • Burkitt Lymphoma / pathology
  • Burkitt Lymphoma / therapy*
  • Cyclophosphamide / therapeutic use
  • Cytarabine / therapeutic use
  • Dexamethasone / therapeutic use
  • Doxorubicin / therapeutic use
  • Etoposide / therapeutic use
  • Genes, Immunoglobulin
  • Hematopoietic Stem Cell Transplantation
  • Humans
  • Ifosfamide / therapeutic use
  • Immunoglobulin Heavy Chains / genetics
  • Male
  • Methotrexate / therapeutic use
  • Molecular Sequence Data
  • Neoplasm Recurrence, Local / genetics*
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Recurrence, Local / therapy*
  • Remission Induction
  • V(D)J Recombination*
  • Vincristine / therapeutic use

Substances

  • Immunoglobulin Heavy Chains
  • Cytarabine
  • Vincristine
  • Etoposide
  • Dexamethasone
  • Doxorubicin
  • Cyclophosphamide
  • Ifosfamide
  • Methotrexate

Supplementary concepts

  • CVAD protocol
  • IVAM regimen