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Aggressive Disease Course of Multiple Myeloma with Concomitant ALK-Negative Anaplastic Large Cell Lymphoma: A Case Report with an Unusual Presentation

ALK-negative anaplastic large cell lymphoma is a rare T-cell neoplasm with an aggressive course requiring prompt diagnostic work-up and treatment. Few cases of concomitant multiple myeloma and T-cell neoplasm are described in the literature, mainly regarding primary cutaneous anaplastic large cell l...

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Autores principales: Staderini, Michela, Mannelli, Lara, Antonioli, Elisabetta, Puccini, Benedetta, Berti, Valentina, Mungai, Francesco, Vergoni, Federica, Carrai, Valentina, Rigacci, Luigi, Bosi, Alberto
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7201522/
https://www.ncbi.nlm.nih.gov/pubmed/32509362
http://dx.doi.org/10.1155/2020/6309736
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author Staderini, Michela
Mannelli, Lara
Antonioli, Elisabetta
Puccini, Benedetta
Berti, Valentina
Mungai, Francesco
Vergoni, Federica
Carrai, Valentina
Rigacci, Luigi
Bosi, Alberto
author_facet Staderini, Michela
Mannelli, Lara
Antonioli, Elisabetta
Puccini, Benedetta
Berti, Valentina
Mungai, Francesco
Vergoni, Federica
Carrai, Valentina
Rigacci, Luigi
Bosi, Alberto
author_sort Staderini, Michela
collection PubMed
description ALK-negative anaplastic large cell lymphoma is a rare T-cell neoplasm with an aggressive course requiring prompt diagnostic work-up and treatment. Few cases of concomitant multiple myeloma and T-cell neoplasm are described in the literature, mainly regarding primary cutaneous anaplastic large cell lymphoma. We present the case of a 65-year-old man, simultaneously diagnosed with ALK-negative anaplastic large cell lymphoma with extranodal localization in the gastrocnemius muscle (stage 1AE) and IgG lambda multiple myeloma (ISS 2, Durie-Salmon stage 3A). Both diseases required therapeutic intervention due to the high proliferative index of lymphoma and the presence of bone lesions attributable to myeloma. The therapeutic program initially included chemotherapy (cyclophosphamide, doxorubicin, vincristine, etoposide, and prednisone; CHOEP), radiotherapy on the leg, bortezomib, and then consolidation with autologous hematopoietic stem cell transplantation. Despite being on bortezomib treatment and waiting for transplantation, the patient experienced an early myeloma progression that turned out to be refractory to second-line lenalidomide-based treatment. To our knowledge, this is the first case of concurrent diagnosis of extranodal ALK-negative anaplastic large cell lymphoma of the muscle and multiple myeloma. Simultaneous onset can be challenging for clinicians as both diseases may have an aggressive course requiring multiple treatments with increased risk of toxicity and complicated management.
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spelling pubmed-72015222020-06-05 Aggressive Disease Course of Multiple Myeloma with Concomitant ALK-Negative Anaplastic Large Cell Lymphoma: A Case Report with an Unusual Presentation Staderini, Michela Mannelli, Lara Antonioli, Elisabetta Puccini, Benedetta Berti, Valentina Mungai, Francesco Vergoni, Federica Carrai, Valentina Rigacci, Luigi Bosi, Alberto Case Rep Hematol Case Report ALK-negative anaplastic large cell lymphoma is a rare T-cell neoplasm with an aggressive course requiring prompt diagnostic work-up and treatment. Few cases of concomitant multiple myeloma and T-cell neoplasm are described in the literature, mainly regarding primary cutaneous anaplastic large cell lymphoma. We present the case of a 65-year-old man, simultaneously diagnosed with ALK-negative anaplastic large cell lymphoma with extranodal localization in the gastrocnemius muscle (stage 1AE) and IgG lambda multiple myeloma (ISS 2, Durie-Salmon stage 3A). Both diseases required therapeutic intervention due to the high proliferative index of lymphoma and the presence of bone lesions attributable to myeloma. The therapeutic program initially included chemotherapy (cyclophosphamide, doxorubicin, vincristine, etoposide, and prednisone; CHOEP), radiotherapy on the leg, bortezomib, and then consolidation with autologous hematopoietic stem cell transplantation. Despite being on bortezomib treatment and waiting for transplantation, the patient experienced an early myeloma progression that turned out to be refractory to second-line lenalidomide-based treatment. To our knowledge, this is the first case of concurrent diagnosis of extranodal ALK-negative anaplastic large cell lymphoma of the muscle and multiple myeloma. Simultaneous onset can be challenging for clinicians as both diseases may have an aggressive course requiring multiple treatments with increased risk of toxicity and complicated management. Hindawi 2020-01-16 /pmc/articles/PMC7201522/ /pubmed/32509362 http://dx.doi.org/10.1155/2020/6309736 Text en Copyright © 2020 Michela Staderini et al. http://creativecommons.org/licenses/by/4.0/ 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.
spellingShingle Case Report
Staderini, Michela
Mannelli, Lara
Antonioli, Elisabetta
Puccini, Benedetta
Berti, Valentina
Mungai, Francesco
Vergoni, Federica
Carrai, Valentina
Rigacci, Luigi
Bosi, Alberto
Aggressive Disease Course of Multiple Myeloma with Concomitant ALK-Negative Anaplastic Large Cell Lymphoma: A Case Report with an Unusual Presentation
title Aggressive Disease Course of Multiple Myeloma with Concomitant ALK-Negative Anaplastic Large Cell Lymphoma: A Case Report with an Unusual Presentation
title_full Aggressive Disease Course of Multiple Myeloma with Concomitant ALK-Negative Anaplastic Large Cell Lymphoma: A Case Report with an Unusual Presentation
title_fullStr Aggressive Disease Course of Multiple Myeloma with Concomitant ALK-Negative Anaplastic Large Cell Lymphoma: A Case Report with an Unusual Presentation
title_full_unstemmed Aggressive Disease Course of Multiple Myeloma with Concomitant ALK-Negative Anaplastic Large Cell Lymphoma: A Case Report with an Unusual Presentation
title_short Aggressive Disease Course of Multiple Myeloma with Concomitant ALK-Negative Anaplastic Large Cell Lymphoma: A Case Report with an Unusual Presentation
title_sort aggressive disease course of multiple myeloma with concomitant alk-negative anaplastic large cell lymphoma: a case report with an unusual presentation
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7201522/
https://www.ncbi.nlm.nih.gov/pubmed/32509362
http://dx.doi.org/10.1155/2020/6309736
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