A Case of Double Expresser Diffuse Large B Cell Lymphoma Treated with R-CODOX-M/R-IVAC.
Chemotherapy
Lymphoma
Pathology
Journal
Case reports in oncology
ISSN: 1662-6575
Titre abrégé: Case Rep Oncol
Pays: Switzerland
ID NLM: 101517601
Informations de publication
Date de publication:
Historique:
received:
04
07
2019
accepted:
11
07
2019
entrez:
24
9
2019
pubmed:
24
9
2019
medline:
24
9
2019
Statut:
epublish
Résumé
Diffuse Large B Cell Lymphoma (DLBCL) is a heterogeneous disease with a variety of chromosomal abnormalities contributing to differences in management. While it is known that Double Hit Lymphomas (DHL) warrant more aggressive chemotherapy regimens, debate remains on how to treat Double Expresser Lymphomas (DEL). We present a case of a DEL treated with an aggressive regimen of 2 alternating cycles of R-CODOX-M (rituximab, cyclophosphamide, doxorubicin, vincristine and methotrexate) and R-IVAC (rituximab, ifosfamide, etoposide and high dose cytarabine). The regimen resulted in a significant response to treatment with marked reduction in tumor size and avidity, and an acceptable side effect profile. There was, however, residual metabolic activity on repeat PET CT scan. After consolidation with 36 Grey radiotherapy, a PET CT demonstrated a complete metabolic response. Debate remains regarding treatment approaches in DEL. Our case supports the categorization of DEL alongside DHL as resistant lymphomas requiring a more aggressive regimen than standard therapy.
Identifiants
pubmed: 31543774
doi: 10.1159/000502087
pii: cro-0012-0595
pmc: PMC6738241
doi:
Types de publication
Case Reports
Langues
eng
Pagination
595-602Déclaration de conflit d'intérêts
The authors have no competing financial interests to disclose.
Références
Blood Cells Mol Dis. 2001 Jan-Feb;27(1):206-16
pubmed: 11358381
N Engl J Med. 2002 Jan 24;346(4):235-42
pubmed: 11807147
Lancet Oncol. 2006 May;7(5):379-91
pubmed: 16648042
Blood. 2008 Sep 15;112(6):2248-60
pubmed: 18612102
Nat Rev Cancer. 2008 Dec;8(12):976-90
pubmed: 19029958
Adv Immunol. 2010;105:193-210
pubmed: 20510734
Mod Pathol. 2012 Jan;25(1):145-56
pubmed: 22002575
Blood. 2013 May 16;121(20):4021-31; quiz 4250
pubmed: 23449635
Blood. 2016 May 19;127(20):2375-90
pubmed: 26980727
J Clin Oncol. 2017 Aug 1;35(22):2515-2526
pubmed: 28525305
Cancer. 2018 Dec 15;124(24):4622-4632
pubmed: 30252929
J Cancer Res Clin Oncol. 2019 Jan;145(1):117-127
pubmed: 30327941
J Clin Oncol. 1996 Mar;14(3):925-34
pubmed: 8622041