To the Editor.—
While substantial numbers of patients with nodular non-Hodgkin's lymphoma survive five years or longer, few are cured of their disease.1 Immune function in these patients is abnormal, even in those who are apparently in complete remission and off all therapy, and they are susceptible to the more common as well as opportunistic infections.2Recently, my experience with a patient with a long history of nodular non-Hodgkin's lymphoma demonstrated the difficulty of diagnosing infection in these patients and dramatically emphasizes the importance of recognizing that what clinically appears to be progressive unresponsive disease may, in fact, be reversible.
Report of a Case.—
In 1974, a 50-year-old woman had an initial diagnosis of nodular mixed lymphoma. The patient received no therapy until 1979, when, because of increasing adenopathy and fever, she was treated with a combination of cyclophosphamide, vincristine sulfate, procarbazine, and prednisone chemotherapy. Her symptoms subsided
Markman M. Chronic Pneumococcal Infection Complicating Progressive Lymphoma. JAMA. 1983;249(3):352–353. doi:10.1001/jama.1983.03330270022017
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