Relapsed refractory nodal peripheral T-cell lymphoma with follicular helper T-cell phenotype was initially resistant to pralatrexate and confirmed to be unresponsive to subsequent forodesine, but responded to re-instituted pralatrexate

摘要

The patient was a 79-year-old Japanese female. She developed multiple areas of swelling in the right axilla and bilateral neck lymph nodes (LNs), in addition to loss of appetite and night sweats. She was diagnosed with peripheral T-cell lymphoma, not otherwise specified (PTCL, NOS) with Ann Arbor clinical stage of IIIB, International Prognostic Score (IPI) of high intermediate (HI) and prognostic index for PTCL-U (PIT) score of 2. Six cycles of CHOP (cyclophosphamide, doxorubicin, vincristine and prednisolone) were administered and complete remission (CR) was confirmed by F18-fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT). After 8 years of remission, she presented with multiple swollen superficial LNs. Left cervical LN biopsy yielded the diagnosis of nodal peripheral T-cell lymphoma with follicular helper T-cell phenotype (nodal PTCL with TFH phenotype) (Figure 1). On immunohistochemistry, the lymphoma cells were positive for CD2, CD3, CD4, CD5, CD7, CD10, PD1 and CCR4, and negative for CD8, CD20 and TIA1.