scholarly journals Intravascular lymphoma presenting with hypoxaemia, platypnoea and lactic acidosis

2021 ◽  
Vol 14 (6) ◽  
pp. e241067
Author(s):  
Pierre Englert ◽  
Sophie Levy ◽  
Marc Vekemans ◽  
Virginie De Wilde
Keyword(s):  
Complete Remission ◽  
Lactic Acidosis ◽  
B Cell ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Multiple Organ ◽  
Rare Type ◽  
Acute Dyspnoea ◽  
Life Threatening ◽  
Relapsed Disease

Intravascular large B-cell lymphoma (IVLBCL) is an aggressive and rare type of diffuse extranodal B-cell lymphoma. Diagnosis and treatment are challenging and clinical presentation is variable. Physicians should be aware of this rare but life-threatening lymphoma without adenopathy and treatment should be promptly started. We describe the case of a 70-year-old woman who presented with general malaise, acute dyspnoea, platypnoea and lactic acidosis. Echocardiography revealed an extracardiac shunt, the cause of her orthodeoxia. The patient developed rapid liver failure and underwent liver biopsy. Anatomopathological findings suggested IVLBCL, non-germinal center type. She achieved complete remission after rituximab, cyclophosphamide, doxorubicin, vincristine, methylprednisolone chemotherapy but relapsed 1 year after initial presentation with multiple organ involvement. The patient’s relapsed disease was treated with rituximab, iphosphamide, carboplatin, etoposide and she is still in complete remission 2 years later.

scholarly journals Nivolumab plus gemcitabine, dexamethasone, and cisplatin chemotherapy induce durable complete remission in relapsed/refractory primary mediastinal B-cell lymphoma: a case report and literature review

2020 ◽  
Vol 48 (8) ◽  
pp. 030006052094507
Author(s):  
Gang Huang ◽  
Ju Huang ◽  
Zhili Zhang ◽  
Chongchong Xue ◽  
Yuan Liu
Keyword(s):  
Complete Remission ◽  
B Cell ◽  
Cell Lymphoma ◽  
Combined Therapy ◽  
B Cell Lymphoma ◽  
Immune Checkpoint Blockade ◽  
Large B Cell Lymphoma ◽  
Clinical Trial Designs ◽  
Potential Use ◽  
Large B Cell

Primary mediastinal large B-cell lymphoma (PMBCL) is an uncommon, but aggressive, type of B-cell lymphoma. Patients with relapsed refractory PMBCL (rrPMBCL) have limited therapeutic options and usually have a relatively poor outcome. Immune checkpoint blockade has become a potential treatment for this disease. We report here a case of a female patient with rrPMBCL who was treated with nivolumab plus gemcitabine, dexamethasone, and cisplatin (GDP) chemotherapy. Complete remission was achieved after four cycles of combined therapy. With continued nivolumab maintenance monotherapy, she has remained in complete remission for longer than 28 months. This is the first report of nivolumab plus GDP chemotherapy inducing complete remission in patient with rrPMBCL. This case supplements the limited literature and provides implications for clinical trial designs regarding the potential use of nivolumab in the treatment of rrPMBCL.

scholarly journals Lactic acidosis: a unique presentation of diffuse large B-cell lymphoma

2019 ◽  
Vol 12 (10) ◽  
pp. e230277 ◽  
Author(s):  
Turab Jawaid Mohammed ◽  
Rohit Gosain ◽  
Rajeev Sharma ◽  
Pallawi Torka
Keyword(s):  
Lactic Acidosis ◽  
B Cell ◽  
Cell Lymphoma ◽  
Performance Status ◽  
B Cell Lymphoma ◽  
Intrathecal Methotrexate ◽  
Dramatic Improvement ◽  
Metabolic Encephalopathy ◽  
Large B Cell Lymphoma ◽  
Large B Cell

An elderly man in the seventh decade of life was brought to the hospital with worsening mental status. Blood tests revealed anaemia and thrombocytopenia with elevated lactate dehydrogenase and serum lactate levels. CT scan showed bulky thoracic and abdominal lymphadenopathy with splenomegaly. A positron emission tomography scan confirmed the above and in addition, revealed bilateral adrenal involvement. Bone marrow biopsy revealed non-germinal centre B-cell-like (non-GCB)-diffuse large B-cell lymphoma (DLBCL). Prompt treatment with dose-adjusted etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin and rituximab with intrathecal methotrexate chemotherapy resulted in a dramatic improvement in the patient’s condition. This vignette serves as a reminder to include aggressive lymphomas like DLBCL in the differential diagnoses of patients presenting with metabolic encephalopathy and lactic acidosis. Our patient was moribund at presentation with poor sensorium and failure to thrive. The dilemma was whether to take an aggressive stand and start chemotherapy urgently or whether to stabilise the patient first and then consider the treatment of DLBCL. We make a case for initiating therapy promptly in such patients irrespective of their performance status.

565: INTRAVASCULAR LARGE B CELL LYMPHOMA PRESENTING AS HEMOPHAGOCYTIC SYNDROME AND TYPE B LACTIC ACIDOSIS

2018 ◽  
Vol 46 (1) ◽  
pp. 267-267
Author(s):  
Gautam Phadke ◽  
Dubert Guerrero ◽  
Avish Nagpal ◽  
Hasrat Khan ◽  
Mazen Kherallah ◽  
...  
Keyword(s):  
Lactic Acidosis ◽  
B Cell ◽  
Hemophagocytic Syndrome ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Type B ◽  
Large B Cell Lymphoma ◽  
Large B Cell

scholarly journals Twenty Years of Autologous Stem Cell Transplantation in Diffuse Large B-Cell Lymphoma: A Single Portuguese Center Experience

2016 ◽  
Vol 29 (3) ◽  
pp. 205
Author(s):  
Margarida Dantas Brito ◽  
Fernando Campilho ◽  
Rosa Branca ◽  
Carlos Vaz ◽  
Susana Roncon ◽  
...  
Keyword(s):  
Stem Cell ◽  
Complete Remission ◽  
Stem Cell Transplantation ◽  
B Cell ◽  
Autologous Stem Cell Transplantation ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Large B Cell Lymphoma ◽  
Large B Cell ◽  
First Complete Remission

<p><strong>Introduction:</strong> Diffuse large B-cell lymphoma can be cured in 60% – 70% of patients. Autologous stem cell transplantation is the standard treatment for relapsed disease. This high-intensity treatment after first complete remission in patients with high International Prognostic Index remains controversial and was performed in our department during some years. <br /><strong>Material and Methods:</strong> Retrospective study, review of clinical records. <br /><strong>Results:</strong> This study evaluates the outcome of 113 patients transplanted between 1992 and 2012. Considering status before transplantation patients were divided in groups: a) first complete remission after 1 line of chemotherapy (n = 64); b) first complete remission after ≥ two chemotherapy lines (n = 15); c) second complete remission (n = 15); d) more advanced diseased (n = 19). Chemotherapy used in first line therapy was mainly R-CHOP (n = 71) and CHOP (n = 28). The median follow-up of patients still alive was 34 months (1 - 221). At five years, overall survival was 73% (± 5) and disease free survival was 75% (± 5).<br /><strong>Conclusion:</strong> Conventional chemotherapy followed by autologous stem cell transplant is a safe and efficient option for selected patients. In our series 70% high-risk patients were free from disease with this strategy.</p>

Iodine-131-anti-B1 radioimmunotherapy for B-cell lymphoma.

1996 ◽  
Vol 14 (7) ◽  
pp. 1974-1981 ◽  
Author(s):  
M S Kaminski ◽  
K R Zasadny ◽  
I R Francis ◽  
M C Fenner ◽  
C W Ross ◽  
...  
Keyword(s):  
Complete Remission ◽  
B Cell ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
High Rate ◽  
Whole Body ◽  
Hematologic Toxicity ◽  
Low Grade ◽  
Tracer Dose ◽  
Iodine 131

PURPOSE The CD20 B-lymphocyte surface antigen expressed by B-cell lymphomas is an attractive target for radioimmunotherapy, treatment using radiolabeled antibodies. We conducted a phase I dose-escalation trial to assess the toxicity, tumor targeting, and efficacy of nonmyeloablative doses of an anti-CD20 monoclonal antibody (anti-B1) labeled with iodine-131 (131I) in 34 patients with B-cell lymphoma who had failed chemotherapy. PATIENTS AND METHODS Patients were first given tracelabeled doses of 131I-labeled anti-B1 (15 to 20 mg, 5 mCi) to assess radiolabeled antibody biodistribution, and then a radioimmunotherapeutic dose (15 to 20 mg) labeled with a quantity of 131I that would deliver a specified centigray dose of whole-body radiation predicted by the tracer dose. Whole-body radiation doses were escalated from 25 to 85 cGy in sequential groups of patients in 10-cGy increments. To evaluate if radiolabeled antibody biodistribution could be optimized, initial patients were given one or two additional tracer doses on successive weeks, each dose preceded by an infusion of 135 mg of unlabeled anti-B1 one week and 685 mg the next. The unlabeled antibody dose resulting in the most optimal tracer biodistribution was also given before the radioimmunotherapeutic dose. Later patients were given a single tracer dose and radioimmunotherapeutic dose preceded by infusion of 685 mg of unlabeled anti-B1. RESULTS Treatment was well tolerated. Hematologic toxicity was dose-limiting, and 75 cGy was established as the maximally tolerated whole-body radiation dose. Twenty-eight patients received radioimmunotherapeutic doses of 34 to 161 mCi, resulting in complete remission in 14 patients and a partial response in eight. All 13 patients with low-grade lymphoma responded, and 10 achieved a complete remission. Six of eight patients with transformed lymphoma responded. Thirteen of 19 patients whose disease was resistant to their last course of chemotherapy and all patients with chemotherapy-sensitive disease responded. The median duration of complete remission exceeds 16.5 months. Six patients remain in complete remission 16 to 31 months after treatment. CONCLUSION Nonmyeloablative radioimmunotherapy with 131I-anti-B1 is associated with a high rate of durable remissions in patients with B-cell lymphoma refractory to chemotherapy.

Primary anaplastic large B-cell lymphoma in mandible: Long-term complete remission with R-CHOP regimen and involved field radiotherapy

Oral Oncology ◽  
2009 ◽  
Vol 45 (9) ◽  
pp. e113
Author(s):  
Pasquale Niscola ◽  
Massimiliano Palombi ◽  
Malgorzata Monika Trawinska ◽  
Laura Scaramucci ◽  
Marco Giovannini ◽  
...  
Keyword(s):  
Complete Remission ◽  
B Cell ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Chop Regimen ◽  
Large B Cell Lymphoma ◽  
Involved Field ◽  
Involved Field Radiotherapy ◽  
Large B Cell
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