case_images: PMC10864495_01
case_images: The timeline and representative PET/CT and CT images. Each treatment the patient received is labeled on the graph. (A) Case 1: Before treatment in November 2021, PET/CT revealed increased glucose metabolism in multiple areas, including the neck, chest, abdomen, bilateral inguinal lymph nodes, occiput, right chest, back, and subcutaneous fat nodules on both upper extremities. Following 3 cycles of CMOP, a PET/CT scan in April 2022 indicated CR, which was sustained after 5 cycles of CMOP in August 2022. Notably, in April 2023, PET-CT confirmed a lasting CR post-ASCT; (B) Case 2: In December 2021, the initial PET/CT revealed enlarged tonsils and right cervical lymph nodes with heightened metabolism. Following 3 cycles of CHOP, a PET/CT scan in June 2022 confirmed CR. Subsequently, after 2 cycles of CMOP in February 2023, another PET/CT displayed CR. However, a CT scan in May 2023 showed enlarged lymph nodes in the mediastinum, and abdominal cavity, marked by red circles; (C) Case 3: In March 2022, pre-treatment CT scans revealed enlarged lymph nodes and a nodule on the right side of the thoracic 12 vertebrae, marked by red circles. Subsequently, a PET/CT scan in July 2022 confirmed CR after 4 cycles of CMOP. Another PET/CT in November 2022 validated sustained CR following 6 cycles of CMOP; (D) Case 4: In June 2022, pre-treatment PET/CT revealed multiple lymph nodes in the neck, chest, and abdomen. Subsequent PET/CT in November 2022 demonstrated CR after 4 cycles of CMOP; (E) Case 5: In May 2022, PET/CT revealed increased glucose metabolism in multiple lymph nodes, bones, and an enlarged spleen, along with pleural effusion. By October 2022, after 4 cycles of CMOP plus thalidomide, PET/CT confirmed CR and the pleural effusion had resolved. PET, positron emission tomography; CT, computed tomography; CR, complete remission; ASCT, autologous stem cell transplantation.
case_images: fonc-14-1331154-g001.jpg
case_images: PMC10864495_05_fonc-14-1331154-g001.jpg
case_images: f1
case_images: A hypermetabolic signal was observed from multiple lymph nodes, bones, and an enlarged spleen on PET/CT ( Figure 1E ). Following the fourth cycle of CMOP plus a thalidomide regimen, Case 5 achieved a CR at PET/CT ( Figure 1E ).
case_images: PMC10864495_02
case_images: The timeline and representative PET/CT and CT images. Each treatment the patient received is labeled on the graph. (A) Case 1: Before treatment in November 2021, PET/CT revealed increased glucose metabolism in multiple areas, including the neck, chest, abdomen, bilateral inguinal lymph nodes, occiput, right chest, back, and subcutaneous fat nodules on both upper extremities. Following 3 cycles of CMOP, a PET/CT scan in April 2022 indicated CR, which was sustained after 5 cycles of CMOP in August 2022. Notably, in April 2023, PET-CT confirmed a lasting CR post-ASCT; (B) Case 2: In December 2021, the initial PET/CT revealed enlarged tonsils and right cervical lymph nodes with heightened metabolism. Following 3 cycles of CHOP, a PET/CT scan in June 2022 confirmed CR. Subsequently, after 2 cycles of CMOP in February 2023, another PET/CT displayed CR. However, a CT scan in May 2023 showed enlarged lymph nodes in the mediastinum, and abdominal cavity, marked by red circles; (C) Case 3: In March 2022, pre-treatment CT scans revealed enlarged lymph nodes and a nodule on the right side of the thoracic 12 vertebrae, marked by red circles. Subsequently, a PET/CT scan in July 2022 confirmed CR after 4 cycles of CMOP. Another PET/CT in November 2022 validated sustained CR following 6 cycles of CMOP; (D) Case 4: In June 2022, pre-treatment PET/CT revealed multiple lymph nodes in the neck, chest, and abdomen. Subsequent PET/CT in November 2022 demonstrated CR after 4 cycles of CMOP; (E) Case 5: In May 2022, PET/CT revealed increased glucose metabolism in multiple lymph nodes, bones, and an enlarged spleen, along with pleural effusion. By October 2022, after 4 cycles of CMOP plus thalidomide, PET/CT confirmed CR and the pleural effusion had resolved. PET, positron emission tomography; CT, computed tomography; CR, complete remission; ASCT, autologous stem cell transplantation.
case_images: fonc-14-1331154-g001.jpg
case_images: PMC10864495_05_fonc-14-1331154-g001.jpg
case_images: f1
case_images: A hypermetabolic signal was observed from multiple lymph nodes, bones, and an enlarged spleen on PET/CT ( Figure 1E ). Following the fourth cycle of CMOP plus a thalidomide regimen, Case 5 achieved a CR at PET/CT ( Figure 1E ).
case_images: PMC10864495_03
case_images: The timeline and representative PET/CT and CT images. Each treatment the patient received is labeled on the graph. (A) Case 1: Before treatment in November 2021, PET/CT revealed increased glucose metabolism in multiple areas, including the neck, chest, abdomen, bilateral inguinal lymph nodes, occiput, right chest, back, and subcutaneous fat nodules on both upper extremities. Following 3 cycles of CMOP, a PET/CT scan in April 2022 indicated CR, which was sustained after 5 cycles of CMOP in August 2022. Notably, in April 2023, PET-CT confirmed a lasting CR post-ASCT; (B) Case 2: In December 2021, the initial PET/CT revealed enlarged tonsils and right cervical lymph nodes with heightened metabolism. Following 3 cycles of CHOP, a PET/CT scan in June 2022 confirmed CR. Subsequently, after 2 cycles of CMOP in February 2023, another PET/CT displayed CR. However, a CT scan in May 2023 showed enlarged lymph nodes in the mediastinum, and abdominal cavity, marked by red circles; (C) Case 3: In March 2022, pre-treatment CT scans revealed enlarged lymph nodes and a nodule on the right side of the thoracic 12 vertebrae, marked by red circles. Subsequently, a PET/CT scan in July 2022 confirmed CR after 4 cycles of CMOP. Another PET/CT in November 2022 validated sustained CR following 6 cycles of CMOP; (D) Case 4: In June 2022, pre-treatment PET/CT revealed multiple lymph nodes in the neck, chest, and abdomen. Subsequent PET/CT in November 2022 demonstrated CR after 4 cycles of CMOP; (E) Case 5: In May 2022, PET/CT revealed increased glucose metabolism in multiple lymph nodes, bones, and an enlarged spleen, along with pleural effusion. By October 2022, after 4 cycles of CMOP plus thalidomide, PET/CT confirmed CR and the pleural effusion had resolved. PET, positron emission tomography; CT, computed tomography; CR, complete remission; ASCT, autologous stem cell transplantation.
case_images: fonc-14-1331154-g001.jpg
case_images: PMC10864495_05_fonc-14-1331154-g001.jpg
case_images: f1
case_images: A hypermetabolic signal was observed from multiple lymph nodes, bones, and an enlarged spleen on PET/CT ( Figure 1E ). Following the fourth cycle of CMOP plus a thalidomide regimen, Case 5 achieved a CR at PET/CT ( Figure 1E ).
case_images: PMC10864495_04
case_images: The timeline and representative PET/CT and CT images. Each treatment the patient received is labeled on the graph. (A) Case 1: Before treatment in November 2021, PET/CT revealed increased glucose metabolism in multiple areas, including the neck, chest, abdomen, bilateral inguinal lymph nodes, occiput, right chest, back, and subcutaneous fat nodules on both upper extremities. Following 3 cycles of CMOP, a PET/CT scan in April 2022 indicated CR, which was sustained after 5 cycles of CMOP in August 2022. Notably, in April 2023, PET-CT confirmed a lasting CR post-ASCT; (B) Case 2: In December 2021, the initial PET/CT revealed enlarged tonsils and right cervical lymph nodes with heightened metabolism. Following 3 cycles of CHOP, a PET/CT scan in June 2022 confirmed CR. Subsequently, after 2 cycles of CMOP in February 2023, another PET/CT displayed CR. However, a CT scan in May 2023 showed enlarged lymph nodes in the mediastinum, and abdominal cavity, marked by red circles; (C) Case 3: In March 2022, pre-treatment CT scans revealed enlarged lymph nodes and a nodule on the right side of the thoracic 12 vertebrae, marked by red circles. Subsequently, a PET/CT scan in July 2022 confirmed CR after 4 cycles of CMOP. Another PET/CT in November 2022 validated sustained CR following 6 cycles of CMOP; (D) Case 4: In June 2022, pre-treatment PET/CT revealed multiple lymph nodes in the neck, chest, and abdomen. Subsequent PET/CT in November 2022 demonstrated CR after 4 cycles of CMOP; (E) Case 5: In May 2022, PET/CT revealed increased glucose metabolism in multiple lymph nodes, bones, and an enlarged spleen, along with pleural effusion. By October 2022, after 4 cycles of CMOP plus thalidomide, PET/CT confirmed CR and the pleural effusion had resolved. PET, positron emission tomography; CT, computed tomography; CR, complete remission; ASCT, autologous stem cell transplantation.
case_images: fonc-14-1331154-g001.jpg
case_images: PMC10864495_05_fonc-14-1331154-g001.jpg
case_images: f1
case_images: A hypermetabolic signal was observed from multiple lymph nodes, bones, and an enlarged spleen on PET/CT ( Figure 1E ). Following the fourth cycle of CMOP plus a thalidomide regimen, Case 5 achieved a CR at PET/CT ( Figure 1E ).
case_images: PMC10864495_05
case_images: The timeline and representative PET/CT and CT images. Each treatment the patient received is labeled on the graph. (A) Case 1: Before treatment in November 2021, PET/CT revealed increased glucose metabolism in multiple areas, including the neck, chest, abdomen, bilateral inguinal lymph nodes, occiput, right chest, back, and subcutaneous fat nodules on both upper extremities. Following 3 cycles of CMOP, a PET/CT scan in April 2022 indicated CR, which was sustained after 5 cycles of CMOP in August 2022. Notably, in April 2023, PET-CT confirmed a lasting CR post-ASCT; (B) Case 2: In December 2021, the initial PET/CT revealed enlarged tonsils and right cervical lymph nodes with heightened metabolism. Following 3 cycles of CHOP, a PET/CT scan in June 2022 confirmed CR. Subsequently, after 2 cycles of CMOP in February 2023, another PET/CT displayed CR. However, a CT scan in May 2023 showed enlarged lymph nodes in the mediastinum, and abdominal cavity, marked by red circles; (C) Case 3: In March 2022, pre-treatment CT scans revealed enlarged lymph nodes and a nodule on the right side of the thoracic 12 vertebrae, marked by red circles. Subsequently, a PET/CT scan in July 2022 confirmed CR after 4 cycles of CMOP. Another PET/CT in November 2022 validated sustained CR following 6 cycles of CMOP; (D) Case 4: In June 2022, pre-treatment PET/CT revealed multiple lymph nodes in the neck, chest, and abdomen. Subsequent PET/CT in November 2022 demonstrated CR after 4 cycles of CMOP; (E) Case 5: In May 2022, PET/CT revealed increased glucose metabolism in multiple lymph nodes, bones, and an enlarged spleen, along with pleural effusion. By October 2022, after 4 cycles of CMOP plus thalidomide, PET/CT confirmed CR and the pleural effusion had resolved. PET, positron emission tomography; CT, computed tomography; CR, complete remission; ASCT, autologous stem cell transplantation.
case_images: fonc-14-1331154-g001.jpg
case_images: PMC10864495_05_fonc-14-1331154-g001.jpg
case_images: f1
case_images: A hypermetabolic signal was observed from multiple lymph nodes, bones, and an enlarged spleen on PET/CT ( Figure 1E ). Following the fourth cycle of CMOP plus a thalidomide regimen, Case 5 achieved a CR at PET/CT ( Figure 1E ).
case_images: Dynamic changes of blood cell count, ferritin, and IL-2R of case 5 during treatment. (A) Dynamic changes of Hb, WBC, PLT, and N during treatment; (B) Dynamic changes of IL-2R. Hb, hemoglobin; WBC, white blood cells; PLT, platelets; N, neutrophils; IL-2R, interleukin 2 receptor.
case_images: fonc-14-1331154-g002.jpg
case_images: PMC10864495_05_fonc-14-1331154-g002.jpg
case_images: f2
case_images: Additionally, Case 5 exhibited symptoms including pancytopenia, low levels of fibrinogen, and high levels of soluble interleukin 2 receptor (IL-2R), suggesting a potential diagnosis of hemophagocytic syndrome ( Figure 2 ). His general condition markedly improved, with normalized blood counts and decreased IL-2R levels ( Figure 2 ).