Prolonged 18FDG-PET negative complete remission in a heavily pretreated, elderly patient with diffuse large B cell lymphoma treated with lenalidomide, low dose dexamethasone, and colony stimulating factor (Rd-G).
Diffuse large B-cell lymphoma (DLBCL) is a common lymphoid malignancy among adults in the developed world and accounts for about a third of all patients newly diagnosed with non-Hodgkin lymphoma each year. The prognosis of patients with DLBCL has improved over the past 10 years since the advent of chemoimmunotherapy regimens such as R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone). However, a significant number of patients still experience disease relapse or progression after first or second line therapy, and ~40% of patients will die within 5 years. In particular, elderly patients and those ineligible for high-dose chemotherapy due to comorbidities require effective salvage treatment options with favorable toxicity profile. Several novel therapeutic approaches have been proposed for these patients including monoclonal antibodies, radioimmunotherapy, proteasome inhibitors, mTOR inhibitors, and the immunomodulatory drugs such as thalidomide and lenalidomide.
Department of Hematology, Istituto Scientifico Romagnolo per Studio e Cura dei Tumori, Meldola, Italy. g.musuraca@irst.emr.it
Gerardo
G
Musuraca
Pier Paolo
PP
Fattori
Michela
M
Ceccolini
Delia
D
Cangini
Maria Benedetta
MB
Giannini
Sonia
S
Ronconi
Federica
F
Matteucci
Silvia
S
Asioli
Dino
D
Amadori
D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003115:Colony-Stimulating Factors / Q000008:administration & dosage; D003907:Dexamethasone / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D000077269:Lenalidomide; D016403:Lymphoma, Large B-Cell, Diffuse / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D049268:Positron-Emission Tomography / Q000379:methods; D019275:Radiopharmaceuticals; D013792:Thalidomide / Q000008:administration & dosage / Q000031:analogs & derivatives
D003115:Colony-Stimulating Factors; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D013792:Thalidomide; D003907:Dexamethasone; D000077269:Lenalidomide