Lenalidomide combined with R-GDP in a patient with refractory CD5-positive diffuse large B-cell lymphoma: A promising response and review

Autor: Yaping Zhang, Chunfeng Sun, Yifei Liu, Wenyu Shi, Xinfeng Wang, Hongming Huang
Rok vydání: 2018
Předmět:
Male
0301 basic medicine
Oncology
Cancer Research
medicine.medical_specialty
medicine.medical_treatment
Salvage therapy
chemical and pharmacologic phenomena
CD5 Antigens
03 medical and health sciences
0302 clinical medicine
immune system diseases
Positron Emission Tomography Computed Tomography
hemic and lymphatic diseases
Internal medicine
Antineoplastic Combined Chemotherapy Protocols
medicine
Humans
Lenalidomide
neoplasms
Pharmacology
Chemotherapy
Bedside to Bench Report
business.industry
Gene Expression Profiling
hemic and immune systems
Middle Aged
medicine.disease
Abdominal mass
Lymphoma
Regimen
Treatment Outcome
030104 developmental biology
Drug Resistance
Neoplasm
030220 oncology & carcinogenesis
Molecular Medicine
Lymphoma
Large B-Cell
Diffuse
CD5
medicine.symptom
business
Diffuse large B-cell lymphoma
medicine.drug
Zdroj: Cancer Biology & Therapy. 19:549-553
ISSN: 1555-8576
1538-4047
Popis: CD5-positive (CD5+) diffuse large B-cell lymphoma (DLBCL) is associated with poor survival compared with CD5-negative DLBCL. The clinical characteristics of CD5+ DLBCL are different from both CD5-negative DLBCL and other CD5+ B cell lymphomas. There is currently no promising chemotherapy for CD5+ DLBCL. Herein, we report a 49-year-old Asian male with refractory CD5+ DLBCL. He complained of aggravated abdominal pain and weight loss. Computed tomography scan revealed abdominal masses, widespread lymphadenopathy, splenomegaly, and intussusception of the ileocecal junction with bowel wall thickening. Core needle aspiration biopsy of an abdominal mass was performed and immunohistochemistry revealed DLBCL of nongerminal center type. In this report, the dose-intensified R-Hyper CVAD (A) regimen as salvage therapy was introduced but failed to result in substantial improvement over the initially standard R-CHOP regimen. Next, the R-GDP regimen was administered as second-line treatment, but only resulted in a partial response. However, the addition of lenalidomide to R-GDP (R2-GDP) resulted in complete remission. The clinical features, pathogenesis, and possible mechanism of action of lenalidomide in CD5+ DLBCL have been described in the literature. The results of the present case report and literature searches indicate that CD5+ DLBCL may share a common pathway with activated B-cell like (ABC) DLBCL as determined by gene expression profiling. Lenalidomide is expected to induce favorable responses in patients with CD5+ DLBCL.
Databáze: OpenAIRE
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