Late-onset neutropenia after chemioimmunotherapy and radiotherapy in a patient with primary mediastinal lymphoma

Abstract

We describe a case report of 30-years-old man with a diagnosis of primary mediastinal B-cell lymphoma (PMBCL) who received 8 cycles of chemioimmunotherapy consisting with rituximab and CHOP every 14 days (R-CHOP-14) and subsequent mediastinal irradiation. Two months after the completion of treatment a profound neutropenia was noted which lasted for 2 months. Trephine biopsy of the bone marrow and subpopulation of peripheral blood lymphocytes as well as negative viruses tests suggested immunologic mechanism of rituximab-induced neutropenia. Transient increasing of neutrophil number was observed after granulocyte-specific colony-stimulating factor (G-CSF) treatment but full recovery of neutrophil count was obtained after short course of steroids administration. Two years and 4 months after completion of treatment, the complete remission of the disease and normal peripheral blood counts were confirmed.