EFFECTIVE HIGH-DOSE CHEMOTHERAPY FOLLOWED BY AUTOLOGOUS PERIPHERAL-BLOOD STEM-CELL TRANSPLANTATION IN A PATIENT WITH THE AGGRESSIVE FORM OFCYTOPHAGIC HISTIOCYTIC PANNICULITIS

A 20-year-old Japanese man developed generalized, subcutaneous, painle ss nodules, fever, abnormal liver function, serosal effusions, hepatos plenomegaly, lymphadenopathy and anemia, Skin biopsies revealed lobula r panniculitis with a morphologically benign histiocytic infiltration and prominent phagocytosis. Atypical T lymphocytes were also present i n the skin and liver, The diagnosis given was aggressive cytophagic hi stiocytic panniculitis (CHP) or aggressive subcutaneous panniculitic T cell lymphoma (SPTCL), He received cyclophosphamide, doxorubicin, and vincristine on day 1, prednisolone on days 1-5, and etoposide on days 1, 3 and 5 (CHOP-E), with the support of granulocyte colony-stimulati ng factor, This regimen was repeated every 2 weeks and complete clinic al remission (CCR) was attained after three cycles of CHOP-E. As the c linical course of aggressive CHP is recurrent and often fatal, he was given high-dose chemotherapy followed by autologous peripheral blood s tem cell transplantation (APBSCT), after five cycles of CHOP-E, He has remained in CCR for 12 months after APBSCT, High-dose chemotherapy fo llowed by APBSCT is considered to be one of the most beneficial therap ies for patients with aggressive CHP and aggressive phase SPTCL.