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Updated: May 1, 2026

Proliferation and Differentiation of Murine Myeloid Precursor 32D/G-CSF-R Cells
Published on: February 21, 2018
Is R-CHOP Therapy a Lymphoma Growth Factor?
Laure Farnault1, Cedric Mercier, Yael Berda-Haddad
11Service d'Hématologie and 2Service d'Hématologie et de Biologie Vasculaire, Centre Hospitalier Universitaire La Conception, Marseille, France; and 3Technologies Avancées pour la Génomique et la Clinique (TAGC)/Unité INSERM U928, Marseille, France.
Abstract:
This article describes the first reported case of dramatic lymphocytosis flare after initiation of R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) therapy for an indolent lymphoma. The study patient exhibited a marginal zone lymphoma with mild nodal involvement but packed infiltration of the bone marrow. After initiation of RCHOP therapy, lymphocyte count increased from 329 to 707 × 10⁹/L at day 7. Patient exhibited grade III infusion-related side effect during rituximab therapy. Lymphocyte flare was not accompanied with other clinical manifestation such as lymph node enlargement. Because patient's bone marrow aspirate showed a packed infiltration, it was hypothesized that lymphocytosis flare was a link to lymphocyte release from bone marrow and lymphocyte demargination. This report highlights the necessity to be vigilant after initiation of RCHOP therapy for lymphoma when pathologist notified a pack infiltration of the bone marrow.
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