Rituximab Treatment of Hairy Cell Leukemia in a Patient with Mycobacterium kansasii Infection: A Case Report. 2021

Carlo Mümmler, and Danmei Zhang, and Andreas Zimmermann, and Pontus Mertsch, and Luca Fischer, and Margarete Greither, and Elham Khatamzas, and Steffen Ormanns, and Marion Heiß-Neumann, and Martin Dreyling, and Michael von Bergwelt-Baildon, and Stefan Boeck
Department of Medicine V, University Hospital, LMU Munich, Munich, Germany.

BACKGROUND Infectious complications represent a major cause of morbidity and mortality in hairy cell leukemia (HCL) patients. Due to the immunosuppressive nature of the disease, these patients are frequently affected by opportunistic infections and rare pathogens. Furthermore, cytotoxic chemotherapy might lead to poor or even fatal outcomes in the setting of an active infection. METHODS We report the case of a 62-year-old HCL patient who presented with recurrent fever episodes, pancytopenia, and mediastinal lymphadenopathy. A treatment decision against purine analogs and for rituximab mono was made as lymph node tissue revealed disseminated Mycobacterium kansasii infection. Together with specific antimycobacterial treatment, rituximab mono led to complete hematologic remission after 6 months without aggravating the accompanying infection. CONCLUSIONS Here, we demonstrate successful treatment of HCL with rituximab in a patient with concomitant disseminated M. kansasii infection.

UI MeSH Term Description Entries
D007943 Leukemia, Hairy Cell A neoplastic disease of the lymphoreticular cells which is considered to be a rare type of chronic leukemia; it is characterized by an insidious onset, splenomegaly, anemia, granulocytopenia, thrombocytopenia, little or no lymphadenopathy, and the presence of "hairy" or "flagellated" cells in the blood and bone marrow. Hairy Cell Leukemia,Leukemic Reticuloendotheliosis,Reticuloendotheliosis, Leukemic,Hairy Cell Leukemias,Leukemias, Hairy Cell,Leukemic Reticuloendothelioses,Reticuloendothelioses, Leukemic
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009165 Mycobacterium Infections, Nontuberculous Infections with nontuberculous mycobacteria (atypical mycobacteria): M. kansasii, M. marinum, M. scrofulaceum, M. flavescens, M. gordonae, M. obuense, M. gilvum, M. duvali, M. szulgai, M. intracellulare (see MYCOBACTERIUM AVIUM COMPLEX;), M. xenopi (littorale), M. ulcerans, M. buruli, M. terrae, M. fortuitum (minetti, giae), M. chelonae, M. leprae. Mycobacterium Infections, Atypical,Atypical Mycobacterial Infection, Disseminated,Atypical Mycobacterial Infection, Familial Disseminated,Atypical Mycobacteriosis, Familial,Atypical Mycobacteriosis, Familial Disseminated,Atypical Mycobacterium Infections,Infections, Atypical Mycobacterium,Mycobacterium abscessus Infection,Atypical Mycobacterium Infection,Familial Atypical Mycobacterioses,Familial Atypical Mycobacteriosis,Infection, Mycobacterium abscessus,Infections, Mycobacterium abscessus,Mycobacterioses, Familial Atypical,Mycobacteriosis, Familial Atypical,Mycobacterium Infection, Atypical,Mycobacterium Infection, Nontuberculous,Mycobacterium abscessus Infections,Nontuberculous Mycobacterium Infection,Nontuberculous Mycobacterium Infections
D009894 Opportunistic Infections An infection caused by an organism which becomes pathogenic under certain conditions, e.g., during immunosuppression. Infection, Opportunistic,Infections, Opportunistic,Opportunistic Infection
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000069283 Rituximab A murine-derived monoclonal antibody and ANTINEOPLASTIC AGENT that binds specifically to the CD20 ANTIGEN and is used in the treatment of LEUKEMIA; LYMPHOMA and RHEUMATOID ARTHRITIS. CD20 Antibody, Rituximab,GP2013,IDEC-C2B8,IDEC-C2B8 Antibody,Mabthera,Rituxan,IDEC C2B8,IDEC C2B8 Antibody,Rituximab CD20 Antibody
D019909 Mycobacterium kansasii A slow-growing, photochromogenic species that is the etiologic agent of a tuberculosis-like disease in humans and is frequently isolated from human pulmonary secretions or tubercles. The incidence of infection is sharply increased among immunocompromised individuals. (Dorland, 28th ed)

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