Abstract
The case of a 16-year-old girl with primary mediastinal large B-cell lymphoma who had thrombosis in the brachiocephalic, subclavian, and internal jugular veins at presentation is reported. MACOP-B chemotherapy plus radiation therapy could be the first-line strategy, but MACOP-B increases the risk of thrombosis. Although an effective method for initial treatment of venous thromboembolism (VTE) in cancer patients has not been established, recent studies revealed that the administration of a low-molecular-weight heparin (LMWH) was effective for secondary prevention of VTE. Therefore, the patient in this case was treated with MACOP-B plus rituximab followed by radiation therapy, and an LMWH was administered through the course of treatment. She achieved complete remission and never suffered from VTE. This case suggests that long-term administration of an LMWH contributes to the primary improvement and secondary prevention of VTE even in patients who are at high risk for thrombosis.
MeSH terms
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Adolescent
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Antibodies, Monoclonal / administration & dosage
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Antibodies, Monoclonal, Murine-Derived
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Antineoplastic Combined Chemotherapy Protocols / administration & dosage
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Bleomycin / administration & dosage
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Combined Modality Therapy
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Cyclophosphamide / administration & dosage
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Doxorubicin / administration & dosage
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Female
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Heparin, Low-Molecular-Weight / therapeutic use*
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Humans
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Leucovorin / administration & dosage
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Lymphoma, Large B-Cell, Diffuse / complications
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Lymphoma, Large B-Cell, Diffuse / drug therapy*
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Mediastinal Neoplasms / complications
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Mediastinal Neoplasms / drug therapy*
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Methotrexate / administration & dosage
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Prednisone / administration & dosage
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Rituximab
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Venous Thromboembolism / drug therapy*
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Venous Thromboembolism / etiology
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Vincristine / administration & dosage
Substances
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Antibodies, Monoclonal
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Antibodies, Monoclonal, Murine-Derived
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Heparin, Low-Molecular-Weight
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Bleomycin
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Rituximab
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Vincristine
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Doxorubicin
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Cyclophosphamide
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Leucovorin
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Prednisone
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Methotrexate