scholarly journals Use of Brentuximab Vedotin in a Non-HIV Patient with Primary Effusion Lymphoma

2021 ◽  
Author(s):  
Joana Ferra ◽  
Filipa Mousinho ◽  
Francisca Miranda ◽  
Sandra André ◽  
Celina Afonso ◽  
...  
Keyword(s):  
Randomized Trials ◽  
Retrospective Studies ◽  
Primary Effusion Lymphoma ◽  
Case Reports ◽  
Therapeutic Option ◽  
B Cell Lymphoma ◽  
Brentuximab Vedotin ◽  
Large B Cell Lymphoma ◽  
Relapsed Disease ◽  
Choice Of Therapy

Primary effusion lymphoma is a rare and aggressive large B-cell lymphoma presenting as malignant effusion with poor prognosis. Although it is more prevalent among HIV patients, it has also been described in non-HIV immunocompromised individuals. Given its rarity, there are no large randomized trials regarding the best therapeutic option. The choice of therapy is based on retrospective studies, case reports and preclinical data. We present the case of a non-HIV patient with relapsed disease after treatment with CHOP who was then successfully treated with brentuximab vedotin, achieving complete remission.

scholarly journals Iris metastasis of diffuse large B-cell lymphoma misdiagnosed as primary angle-closure glaucoma: A case report and review of the literature

2021 ◽  
Vol 16 (1) ◽  
pp. 61-68
Author(s):  
Zebing Li ◽  
Zhongjing Lin ◽  
Yisheng Zhong ◽  
Xi Shen
Keyword(s):  
B Cell ◽  
Cell Lymphoma ◽  
Case Reports ◽  
Therapeutic Option ◽  
B Cell Lymphoma ◽  
Angle Closure ◽  
Pathological Examination ◽  
Iris Metastasis ◽  
Large B Cell Lymphoma ◽  
Large B Cell

Abstract Background Lymphoma with intraocular metastasis is an uncommon and serious disease. We describe a case of diffuse large B-cell lymphoma (DLBCL) with iris metastasis. Meanwhile, we refer to published case reports retrieved via a PubMed search to summarize this rare disease. Case presentation Glaucoma and uveitis symptoms were found in the left eye of a 50-year-old woman upon admission to the hospital. After treatment and pathological examination, the iris of her left eye was diagnosed with DLBCL. Given the patient’s unfavorable treatment options in the local hospital, primary enucleation was offered as a therapeutic option. Conclusions Iris metastasis of systemic lymphoma is an extremely rare ophthalmic disease with poor prognosis. Ophthalmologists should be able to definitively and differentially diagnose eye symptoms and pay attention to systemic conditions to provide a series of optimized treatments.

Brentuximab vedotin in combination with lenalidomide and rituximab in subjects with relapsed or refractory diffuse large B-cell lymphoma (DLBCL) (Trials in Progress).

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. TPS7571-TPS7571
Author(s):  
Nancy L. Bartlett ◽  
Christopher A. Yasenchak ◽  
Khaleel K. Ashraf ◽  
William N. Harwin ◽  
Robert Brownell Sims ◽  
...  
Keyword(s):  
Stem Cell ◽  
Stem Cell Transplant ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Brentuximab Vedotin ◽  
Cell Transplant ◽  
Large B Cell Lymphoma ◽  
Car T ◽  
Secondary Endpoints ◽  
Large B Cell

TPS7571 Background: The majority of patients (pts) with relapsed/refractory (R/R) diffuse large B-cell lymphoma (DLBCL) who relapse after HSCT, or who are not candidates for HSCT have poor outcomes and are in need of novel therapies. Brentuximab vedotin (BV) is a CD30-directed ADC and preclinical data provide a strong rationale for combining BV, lenalidomide, and rituximab in the treatment of R/R DLBCL. In addition, in a phase 1 trial in which 37 pts with R/R DLBCL were treated with BV + lenalidomide, the ORR was 56.7% (73.3% in CD30+ pts; manuscript in preparation). The median duration of remission was 13.2 months in pts with a CR or PR and 11.7 months in pts with CR, PR, or stable disease > 6 months. The PFS and median OS were 11.2 months and 14.3 months, respectively and results were similar in the CD30+ and CD30 < 1% groups. The clinical activity and manageable safety profiles of BV, lenalidomide, and rituximab as single agents, make the combination a viable option in multiply relapsed and heavily pretreated pts. Methods: This is a randomized, double-blind, placebo-controlled, active-comparator, multicenter phase 3 study designed to evaluate the efficacy of BV vs placebo, in combination with lenalidomide + rituximab, in subjects with R/R DLBCL (NCT04404283). Prior to randomization, there will be a safety and PK run-in period where 6 pts will receive BV, lenalidomide + rituximab, and safety and PK will be evaluated after the first cycle of treatment; 6/6 subjects have been enrolled. Key eligibility criteria include: pts aged ≥18 with R/R DLBCL with an eligible subtype; ≥2 prior lines of therapy and must be ineligible for, or have declined, stem cell transplant, and chimeric antigen receptor T-cell (CAR-T) therapy; ECOG 0 to 2; fluorodeoxyglucose-avid disease by PET and bidimensional measurable disease of at least 1.5 cm by CT. Patients (n = 400) will be randomized 1:1 to receive either BV or placebo in combination with lenalidomide + rituximab and will be stratified by CD30 expression (positive [ ≥1%] versus < 1%), prior allogeneic or autologous stem cell transplant therapy (received or not), prior CAR-T therapy (received or not), and cell of origin (GCB or non-GCB). The primary endpoints are PFS per BICR in the ITT and CD30+ populations. Key secondary endpoints are OS in the ITT and CD30+ populations, and ORR per BICR. Other secondary endpoints include CR rate, duration of response, and safety and tolerability of the combination. Disease response will be assessed by BICR and the investigator according to the Lugano Classification Revised Staging System. Radiographic disease evaluations, including contrast-enhanced CT scans and PET, will be assessed at baseline, then every 6 weeks from randomization until Week 48, then every 12 weeks. PET is not required after CR is achieved. The trial is currently enrolling and will be open in 16 countries. Clinical trial information: NCT04404283.

scholarly journals Intravascular Lymphoma in Patient With Celiac Disease With Multi Glandular Involvement

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A938-A939
Author(s):  
Mustafa Alam ◽  
Mohamad Hosam Horani
Keyword(s):  
Celiac Disease ◽  
B Cell ◽  
Cell Lymphoma ◽  
Case Reports ◽  
B Cell Lymphoma ◽  
Diagnostic Challenge ◽  
Pituitary Microadenoma ◽  
Non Hodgkin Lymphoma ◽  
Large B Cell Lymphoma ◽  
History Of

Abstract Case Presentation: The patient is a 60 year old male with a past medical history of celiac disease, paroxysmal Afib, iron deficiency, and CAD who presented with lightheadedness, dizziness, and fatigue. Notable workup revealed that the patient had Afib with RVR, a TSH of 0.189, Free t4 0.51an LDH of 2726, hemoglobin of 8.7, AST of 155, ALT of 19, WBC of 4.5, and serum iron of 20. The patient’s cardizem dose was adjusted and repeat transthoracic echocardiogram was unremarkable compared to history. The patient presented again with complaints of abdominal distension, postural dizziness, occasional night sweats, and fevers. Repeat workups revealed pancytopenia, proteinuria, hypotension, and anasarca most pronounced in the lower extremity and scrotum. Ultimately, a kidney biopsy revealed an intravascular B cell non-Hodgkin lymphoma (IVBCL). Notable repeat labs include a CRP of 44 and a failed ACTH stimulation test. A brain MRI revealed a 6mm pituitary microadenoma. The patient placed on an R-CHOP regiment and is scheduled for repeat MRI to rule out pituitary involvement. Discussion: IVBCL’s are a rare form of diffuse B cell lymphoma and remain a diagnostic challenge due to the variety of involved systems including skin, CNS, and endocrine. IVBCL is also known to not produce a mass or lymphadenopathy. Celiac disease is a known risk factor for non-Hodgkin’s lymphoma. A literature search reveals a few case reports with common themes of increased LDH and inflammatory markers, anemia, and hepatic and renal dysfunction. Postural hypotension can also be a presenting symptom due to IVBCL’s ability to infiltrate neurovascular tissue to cause autonomic neuropathy. However, in this case, the patient’s history of primary adrenal insufficiency makes this unlikely. Hypothyroidism secondary to pituitary and thyroid involvement was suspected due to TSH level suppressed enough for central hypothyroidism. Repeated MRI showed resolution of Pituitary Microadenoma post Chemo therapy. Sylvain Raoul Simeni Njonnou, Bruno Couturier, Yannick Gombeir, Sylvain Verbanck, France Devuyst, Georges El Hachem, Ivan Theate, Anne-Laure Trepant, Virginie De Wilde, Frédéric-Alain Vandergheynst, “Pituitary Gland and Neurological Involvement in a Case of Hemophagocytic Syndrome Revealing an Intravascular Large B-Cell Lymphoma”, Case Reports in Hematology, vol. 2019, 6 pages, 2019. https://doi.org/10.1155/2019/9625075 Catassi C, Fabiani E, Corrao G, et al. Risk of Non-Hodgkin Lymphoma in Celiac Disease. JAMA. 2002;287(11):1413 Khan MS, McCubbin M, Nand S. Intravascular Large B-Cell Lymphoma: A Difficult Diagnostic Challenge. J Investig Med High Impact Case Rep. 2014 Mar 6;2(1):2324709614526702. Pearce C, Hope S, Butchart J. Intravascular lymphoma presenting with postural hypotension. BMJ Case Rep. Published 2018 Jan 29.

scholarly journals Primary Bone Lymphoma in Axial Skeleton in a Middle-Aged Female Presented as Recurrent Anemia

2020 ◽  
Vol 13 (1) ◽  
pp. 276-280
Author(s):  
Tala Batia ◽  
Mohamed A. Yassin ◽  
Deena S. Mudawi ◽  
Omnia A. Hamid ◽  
Ahmed M.A. Abdalhadi
Keyword(s):  
Cell Lymphoma ◽  
Case Reports ◽  
B Cell Lymphoma ◽  
Axial Skeleton ◽  
Primary Bone Lymphoma ◽  
Large B Cell Lymphoma ◽  
Pathological Type ◽  
Primary Bone ◽  
Insight Into ◽  
Bone Lymphoma

Primary bone lymphoma (PBL) is a peculiar extranodal presentation of non-Hodgkin’s lymphoma. Primary bone diffuse large B-cell lymphoma (DLBCL) is the most common pathological type, comprising about 80% of PBL. The diagnosis of PBL depends on the combined clinical examination and imaging studies and is confirmed with immunohistochemical examination. Due to the rarity of this disease, more relative studies and case reports are needed to provide insight into this obscure lymphoproliferative malignancy. Here, we report one rare case of primary bone DLBCL involving the axial skeleton in a 37-year-old female.

Classical Hodgkin lymphoma primary refractory to brentuximab vedotin, with transformation to CD30-positive diffuse large B-cell lymphoma

2016 ◽  
Vol 104 (3) ◽  
pp. 396-399 ◽  
Author(s):  
Shinichi Makita ◽  
Akiko Miyagi Maeshima ◽  
Hirokazu Taniguchi ◽  
Hideaki Kitahara ◽  
Suguru Fukuhara ◽  
...  
Keyword(s):  
B Cell ◽  
Hodgkin Lymphoma ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Brentuximab Vedotin ◽  
Classical Hodgkin Lymphoma ◽  
Large B Cell Lymphoma ◽  
Large B Cell

Lenalidomide in Combination with R-ESHAP (LR-ESHAP) in Patients with Relapsed or Refractory Diffuse Large B-Cell Lymphoma Who Are Candidates for Autologous Stem-Cell Transplantation: A Phase 2 Study from the Spanish Group Geltamo

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 1850-1850
Author(s):  
Alejandro Martín ◽  
Mónica Baile ◽  
Guillermo Rodríguez ◽  
Ivan Dlouhy ◽  
Juan Manuel Sancho ◽  
...  
Keyword(s):  
Stem Cell ◽  
Board Of Directors ◽  
Colon Adenocarcinoma ◽  
B Cell Lymphoma ◽  
Phase 2 ◽  
First Line ◽  
Advisory Committees ◽  
Large B Cell Lymphoma ◽  
Phase 1B ◽  
Relapsed Disease

Abstract Background: Diffuse large B-cell lymphoma (DLBCL) patients with relapsed or refractory disease after rituximab-containing first-line therapy have poor outcomes with current salvage regimens. Accordingly, prospective studies incorporating new agents are needed for these patients. We conducted a phase 1b/2 trial to analyze the safety and efficacy of lenalidomide in combination with R-ESHAP (LR-ESHAP) in patients with relapsed or refractory DLBCL. The phase 1b part of the trial has been completed and lenalidomide 10 mg/day was identified as the maximum tolerated dose (MTD) (Martín et al, Br J Haematol 2016; 173: 245-52). Here we present the preliminary results of the phase 2 (ClinicalTrials.gov Identifier: NCT02340936). Patients and methods: Eligible patients must be refractory to, or have relapsed following first-line treatment with rituximab in combination with an anthracycline-containing regimen and be eligible for autologous stem-cell transplantation (ASCT). Subjects received 3 cycles of lenalidomide 10 mg given on days 1 to 14 of every 21-day cycle, in combination with R-ESHAP salvage chemotherapy at standard doses (rituximab 375 mg/m2 day 1, etoposide 40 mg/m2 days 1-4, cisplatin 25 mg/m2 days 1-4, cytarabine 2000 mg/m2 day 5, and methylprednisolone 500 mg days 1-5). Responding patients received BEAM followed by ASCT. The primary endpoint was overall response rate (ORR) after 3 cycles of therapy. Secondary endpoints were complete remission (CR) rate, stem-cell mobilization activity, progression-free and overall survival, and toxicity. Results: Patient characteristics: 46 patients were included in the phase 2 analysis, of whom 12 were enrolled between January 2012 and March 2013, and had been given the MTD during phase 1; 34 were enrolled between January 2015 and November 2015. Median age was 58 (23-69) years, and 56.5% were male. Evaluable population per-protocol consisted of 44 patients because 2 patients were excluded during the first cycle due to withdrawal of consent and centralized diagnosis at relapse of lymphoblastic lymphoma, respectively. First-line treatment consisted of R-CHOP or similar in 38 patients, R-EPOCH in 3, VR-CAP in 1, and Burkitt lymphoma protocols in 2. Disease status at LR-ESHAP was: primary refractory disease in 67% of patients (partial response [PR] after first-line, n=13; and stable or progressive disease [<PR] after first-line, n=16), and relapsed disease in 33% (5 relapses occurred <1 year from diagnosis, and 10 late relapses). IPI was 0-1 in 38%, 2-3 in 48%, and 4-5 in 14%. Feasibility and efficacy: 40 out of 44 patients (91%) received the planned 3 cycles of treatment (2 without lenalidomide in the third cycle due to toxicity) and 2 patients two cycles (due to persistent hematological and renal toxicities, respectively). Two patients discontinued treatment during the first cycle due to grade 3 infections (fungal pulmonary infection and mastoiditis, respectively). ORR to LR-ESHAP in the per-protocol population (n=44) was 68% (41% CR). Patients with relapsed disease had significantly better ORR and CR rates (87% and 67%, respectively) than patients in PR (77% and 31%) or <PR (37% and 25%) (p=0.004 and 0.02, respectively). Evaluation of response according to cell of origin (COO) is ongoing. Thirty-nine out of 42 patients (93%) were successfully mobilized after one (n=32) or two (n=7) mobilization procedures, and 28 (64%) underwent ASCT according to protocol, 1 of them after bone-marrow harvest. Reasons for not performing the transplant were: early progression (n=13), trial discontinuation due to toxicity (n=2), mobilization failure (n=1), and diagnosis of colon adenocarcinoma (n=1). Toxicity: 42 serious adverse events (SAEs) have been reported during 128 cycles of treatment, including 14 episodes of febrile neutropenia (11%), 12 infections (9%), 2 renal disorders, 3 cardiac disorders, 3 thrombosis, and 8 other toxicities. All of them recovered except 1 case of colon adenocarcinoma in a patient with previous adenoma in the same location. There were no treatment-related deaths during LR-ESHAP cycles. Conclusions: LR-ESHAP is safe, feasible and associated with high response rates in rituximab-pretreated relapsed or refractory DLBCL patients. Longer follow-up is needed to perform survival analysis. Efficacy analysis according to COO is ongoing. Disclosures Martín: Janssen: Honoraria; Celgene: Honoraria, Membership on an entity's Board of Directors or advisory committees; Sevier: Honoraria, Membership on an entity's Board of Directors or advisory committees; Gilead: Membership on an entity's Board of Directors or advisory committees. González-Barca:Sanofi: Membership on an entity's Board of Directors or advisory committees; Servier: Honoraria, Membership on an entity's Board of Directors or advisory committees; Gilead: Honoraria; Janssen: Honoraria, Membership on an entity's Board of Directors or advisory committees; Roche: Honoraria. Lopez-Guillermo:Roche: Consultancy, Research Funding; Celgene: Consultancy; Gilead: Consultancy; Janssen: Consultancy; Mundipharma: Consultancy.

scholarly journals Rituximab Maintenance Therapy After Autologous Stem-Cell Transplantation in Patients With Relapsed CD20+ Diffuse Large B-Cell Lymphoma: Final Analysis of the Collaborative Trial in Relapsed Aggressive Lymphoma

2012 ◽  
Vol 30 (36) ◽  
pp. 4462-4469 ◽  
Author(s):  
Christian Gisselbrecht ◽  
Norbert Schmitz ◽  
Nicolas Mounier ◽  
Devinder Singh Gill ◽  
David C. Linch ◽  
...  
Keyword(s):  
Stem Cell ◽  
Stem Cell Transplantation ◽  
B Cell ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Salvage Chemotherapy ◽  
High Dose ◽  
Large B Cell Lymphoma ◽  
Relapsed Disease ◽  
Large B Cell

Purpose The standard treatment for relapsed diffuse large B-cell lymphoma (DLBCL) is salvage chemotherapy followed by high-dose therapy and autologous stem-cell transplantation (ASCT). The impact of maintenance rituximab after ASCT is not known. Patients and Methods In total, 477 patients with CD20+ DLBCL who were in their first relapse or refractory to initial therapy were randomly assigned to one of two salvage regimens. After three cycles of salvage chemotherapy, the responding patients received high-dose chemotherapy followed by ASCT. Then, 242 patients were randomly assigned to either rituximab every 2 months for 1 year or observation. Results After ASCT, 122 patients received rituximab, and 120 patients were observed only. The median follow-up time was 44 months. The 4-year event-free survival (EFS) rates after ASCT were 52% and 53% for the rituximab and observation groups, respectively (P = .7). Treatment with rituximab was associated with a 15% attributable risk of serious adverse events after day 100, with more deaths (six deaths v three deaths in the observation arm). Several factors affected EFS after ASCT (P < .05), including relapsed disease within 12 months (EFS: 46% v 56% for relapsed disease after 12 months), secondary age-adjusted International Prognostic Index (saaIPI) more than 1 (EFS: 37% v 61% for saaIPI < 1), and prior treatment with rituximab (EFS: 47% v 59% for no prior rituximab). A significant difference in EFS between women (63%) and men (46%) was also observed in the rituximab group. In the Cox model for maintenance, the saaIPI was a significant prognostic factor (P < .001), as was male sex (P = .01). Conclusion In relapsed DLBCL, we observed no difference between the control group and the rituximab maintenance group and do not recommend rituximab after ASCT.

scholarly journals Gastrosplenic Fistula Due to Splenic Lymphoma: Two Case Reports and Literature Review

2021 ◽  
Author(s):  
Feryel Ksontini Letaief ◽  
Issaad Nefzi ◽  
salim khrouf ◽  
Sonia ouali ◽  
Asma Zidi ◽  
...  
Keyword(s):  
Case Reports ◽  
Splenic Abscess ◽  
Rare Condition ◽  
B Cell Lymphoma ◽  
Review Literature ◽  
Treatment Modalities ◽  
Large B Cell Lymphoma ◽  
First Case ◽  
Splenic Lymphoma ◽  
Dangerous Condition

Abstract PurposeGastrosplenic fistula (GSF) is a rare and potentially fatal complication of various diseases, of which lymphoma is the most common cause. We aim through our work to relate two cases of GSF and to review literature. Methods We reviewed two cases treated in our department of GSF and made a research in Pubmed using the keywords “Gastrosplenic fistula” and “Splenic lymphoma”.Results GSF is a rare condition that can occur spontaneously or after initiation of chemotherapy. It arises from the rapid growth of tumour and invasion of surrounding organs. Diagnosis may be difficult to make and confused with splenic abscess. Treatment modalities include surgical resection, chemotherapy or a combination of both. Here we report two cases of GSF due to diffuse large B cell lymphoma patients. The first case is of a 54-year-old woman with a spontaneous fistula in the stomach. The second one is of a 48 year-old- male patient presenting a fistula after chemotherapy. Both patients died after surgery. ConclusionGSF is a rare but dangerous condition in which surgery is currently the preferred treatment.

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