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Case Reports
Warburg effect associated with transformed lymphoplasmacytic lymphoma to diffuse large B-cell lymphoma.
- Saranya Buppajarntham, Parichart Junpaparp, and Pongsathorn Kue-A-Pai.
- Albert Einstein Medical Center, Philadelphia, PA 19141, USA. BuppajaS@einstein.edu
- Am J Emerg Med. 2013 Jun 1;31(6):999.e5-6.
AbstractWarburg effect is a rare metabolic complication in hematologic malignancies, commonly presented with lactic acidosis and hypoglycemia. Mechanism explained by abnormality of mitochondrial oxidative phosphorylation in cancer cells and energy production is mostly dependent on anaerobic respiration or glycolysis pathway to meet large tumor demand. We present a case with history of lymphoplasmacytic lymphoma and Waldenstörm macroglobulinemia, partial response to chemotherapy. Lymphoplasmacytic lymphoma transformed to diffuse large B-cell lymphoma, which is aggressive and rapid progression, leading to Warburg effect. Patient developed more than 10-cm retroperitoneal mass less than 1 year, and his symptoms were progressively worsening within 3 weeks. Warburg effect represents poor prognosis no matter with or without hypoglycemia. Treatment of choice is cytoreduction with early chemotherapy. Our patient died 2 days after Warburg effect occurred.
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