PMC5513489_01
Time course of lipoprotein profile changes in a patient with IVLBCL. Upper panel: historical lipid values 6 3 years (2303 days) before time of presentation (purple arrow) and subsequent time points (104 days) prior to EPOCH-Rituximab treatment (black arrow). The lower panel highlights the appearance of very low levels of HDL-C 4 5 months prior to presentation (purple arrow) and the recovery of lipid values after initiating EPOCH-Rituximab therapy (black arrow).
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F1
A review of his laboratory tests revealed that his HDL-C had progressively dropped, from a relatively normal level of 40 mg/dL about two years earlier, to 29 mg/dL one year prior to presentation (Fig. 1). Concurrently, low-density lipoprotein-cholesterol (LDL-C) also decreased prior to presentation, although less markedly, and triglycerides (TG) increased during this time period (Fig. 1). Neutral lipid staining of lipoproteins separated by size by non-denaturing polyacrylamide gel electrophoresis also showed very low levels of HDL, which were mostly comprised of small HDL particles (Supplemental Fig. 1S). Twenty-four days after the first cycle of chemotherapy, HDL-C levels recovered to near-normal levels (38 mg/dL) (Fig. 1, Fig. 2A).
Recovery of HDL-C and other lipoproteins after initiating therapy in patients with B-cell disorders. (AC) Recovery of lipids after EPOCH-Rituximab treatment in (A) Patient 1 (IVBCL); (B) Patient 2 (IVBCL), and (C) Patient 3 (DLBCL). The first time point ("Day 0") represents the last lipid time point before initiating EPOCH-Rituximab treatment (black arrow). D. Patient 4. HDL-C increase and TG decrease in ALPS patient following treatment. TG, triglycerides; ApoA-I; apolipoprotein A-I. MMF, mycophenolate mofetil; P, prednisone. P* denotes the 9-day increase in prednisone to 15 mg/day.
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F2
Analysis of a blood sample collected at 14 months of age revealed a total cholesterol level of 104, HDL-C of 3, LDL-C of 66, TG of 175, apoA-I of 40, and apoB of 44 (all mg/dL) (Fig. 2D). HDL-C increased slightly but was still very low (Fig. 2D). As the lymphadenopathy and cytopenias improved with immunosuppression therapy, the patient's HDL-C increased to 40 mg/dL and her triglycerides decreased to 80 mg/dL (Fig. 2D). 3 years later, her lymphoproliferation is in remission on sirolimus and her HDL-C has remained normal (Fig. 2D).
PMC5513489_02
Recovery of HDL-C and other lipoproteins after initiating therapy in patients with B-cell disorders. (AC) Recovery of lipids after EPOCH-Rituximab treatment in (A) Patient 1 (IVBCL); (B) Patient 2 (IVBCL), and (C) Patient 3 (DLBCL). The first time point ("Day 0") represents the last lipid time point before initiating EPOCH-Rituximab treatment (black arrow). D. Patient 4. HDL-C increase and TG decrease in ALPS patient following treatment. TG, triglycerides; ApoA-I; apolipoprotein A-I. MMF, mycophenolate mofetil; P, prednisone. P* denotes the 9-day increase in prednisone to 15 mg/day.
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F2
Analysis of a blood sample collected at 14 months of age revealed a total cholesterol level of 104, HDL-C of 3, LDL-C of 66, TG of 175, apoA-I of 40, and apoB of 44 (all mg/dL) (Fig. 2D). HDL-C increased slightly but was still very low (Fig. 2D). As the lymphadenopathy and cytopenias improved with immunosuppression therapy, the patient's HDL-C increased to 40 mg/dL and her triglycerides decreased to 80 mg/dL (Fig. 2D). 3 years later, her lymphoproliferation is in remission on sirolimus and her HDL-C has remained normal (Fig. 2D).
PMC5513489_03
Recovery of HDL-C and other lipoproteins after initiating therapy in patients with B-cell disorders. (AC) Recovery of lipids after EPOCH-Rituximab treatment in (A) Patient 1 (IVBCL); (B) Patient 2 (IVBCL), and (C) Patient 3 (DLBCL). The first time point ("Day 0") represents the last lipid time point before initiating EPOCH-Rituximab treatment (black arrow). D. Patient 4. HDL-C increase and TG decrease in ALPS patient following treatment. TG, triglycerides; ApoA-I; apolipoprotein A-I. MMF, mycophenolate mofetil; P, prednisone. P* denotes the 9-day increase in prednisone to 15 mg/day.
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F2
Analysis of a blood sample collected at 14 months of age revealed a total cholesterol level of 104, HDL-C of 3, LDL-C of 66, TG of 175, apoA-I of 40, and apoB of 44 (all mg/dL) (Fig. 2D). HDL-C increased slightly but was still very low (Fig. 2D). As the lymphadenopathy and cytopenias improved with immunosuppression therapy, the patient's HDL-C increased to 40 mg/dL and her triglycerides decreased to 80 mg/dL (Fig. 2D). 3 years later, her lymphoproliferation is in remission on sirolimus and her HDL-C has remained normal (Fig. 2D).
PMC5513489_04
Recovery of HDL-C and other lipoproteins after initiating therapy in patients with B-cell disorders. (AC) Recovery of lipids after EPOCH-Rituximab treatment in (A) Patient 1 (IVBCL); (B) Patient 2 (IVBCL), and (C) Patient 3 (DLBCL). The first time point ("Day 0") represents the last lipid time point before initiating EPOCH-Rituximab treatment (black arrow). D. Patient 4. HDL-C increase and TG decrease in ALPS patient following treatment. TG, triglycerides; ApoA-I; apolipoprotein A-I. MMF, mycophenolate mofetil; P, prednisone. P* denotes the 9-day increase in prednisone to 15 mg/day.
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F2
Analysis of a blood sample collected at 14 months of age revealed a total cholesterol level of 104, HDL-C of 3, LDL-C of 66, TG of 175, apoA-I of 40, and apoB of 44 (all mg/dL) (Fig. 2D). HDL-C increased slightly but was still very low (Fig. 2D). As the lymphadenopathy and cytopenias improved with immunosuppression therapy, the patient's HDL-C increased to 40 mg/dL and her triglycerides decreased to 80 mg/dL (Fig. 2D). 3 years later, her lymphoproliferation is in remission on sirolimus and her HDL-C has remained normal (Fig. 2D).