Pleural effusion or ascites complicating plasmacytoma is rare and has a poor prognosis. A 70-year-old man was diagnosed as plasma cell leukemia and one course of ranimustine-vindesine, melphalan, and prednisolone followed by melphalan and prednisone (MP) maintained a very good partial response. After MP he was diagnosed to have pleural effusion and ascites as a complication of the plasmacytoma. Low-dose bortezomib caused disappearance of the malignant effusion. The malignant effusions recurred after the end of the second course of bortezomib. High-dose dexamethasone vincristine, doxorubicin, cyclophosphamide, and prednisone yielded no benefit, the patient died of Aspergillus pneumonia.
A 53-year-old woman had been diagnosed with rheumatoid arthritis (RA) in X-6. She was started on methotrexate (MTX) in X-1. She developed a cough, and chest computed tomography showed abnormalities. In X, MTX was discontinued, but the cough persisted. A lung biopsy revealed a diagnosis of nodular sclerosis classic Hodgkin lymphoma (CHL-NS). She was considered to have "other iatrogenic immunodeficiencyassociated lymphoproliferative disorders" (OIIA-LPD), MTX-associated Hodgkin lymphoma (MTX-HL). She received six courses of brentuximab vedotin (BV) in addition to AVD (BV+AVD). A complete metabolic response was obtained, and the RA went into remission. This is the fourth reported case of BV+AVD for MTX-HL.
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