Intractible cutaneous non-Hodgkin's lymphoma of the lower limb. Complete remission after sequential regional isolated hyperthermic perfusion and perfusion with 1-phenylalanine-mustard (melphalan, L-pam)
✍ Scribed by Ruud F. M. Jansen; Bert N. van Geel; Jacoba Van de rzee; Anton Hagenbeek; Peter C. Levendag
- Publisher
- John Wiley and Sons
- Year
- 1989
- Tongue
- English
- Weight
- 369 KB
- Volume
- 64
- Category
- Article
- ISSN
- 0008-543X
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✦ Synopsis
A 61-year-old man with an intractible and progressively disabling cutaneous non-Hodgkin's lymphoma (NHL) in the lower limb was treated with sequential regional isolated perfusion at 10-day intervals. The first perfusion was hyperthermic (40.2-43.1 "C tumor-temperature); the second was at controlled normothermia with high-dose I-phenylalanine mustard (melphalan, L-Pam; 11 mg/l perfused tissue). This treatment resulted in a complete remission in the perfused area of significant duration and has prevented amputation.
Cancer 64392-395.1989.
UTANEOUS MANIFESTATION OF non-Hodgkin's C lymphoma (NHL) is seen in 20% of primarily diagnosed NHL patients. Of these, approximately one third are of low-grade malignant B-cell type.' Depending on the degree of extracutaneous involvement, radiotherapy, chemotherapy, or both is the treatment of choice. In particular, in patients with intermediate-or high-grade malignant NHL involving the skin, relapses are frequently observed. However, relapses limited to the skin are rare.
In this article, a patient is presented with a progressive cutaneous manifestation of NHL despite extensive chemotherapy and radiotherapy. This multitherapy-resistant, progressively disabling cutaneous NHL was treated with sequential isolated regional perfusion with hyperthermia and high-dose chemotherapy, resulting in a complete remission of significant duration.
Case Report
A 49-year old man was treated in 1974 for Stage I diffuse centrocytic-centroblastic NHL located in a right submandibular lymph node. Treatment consisted of radiotherapy to the supra-