title: A highly therapy-resistant case of B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma and Burkitt lymphoma showing strong BCL2 staining, otherwise indistinguishable from Burkitt lymphoma.
abstract: B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma and Burkitt lymphoma (iDLBCL/BL) is a newly categorized lymphoma in the WHO Classification of Tumors of Haematopoietic and Lymphoid Tissues v4. This lymphoma has characteristics of both DLBCL and BL, morphologically and genetically. We report a case with therapy-resistant iDLBCL/BL, which used to be categorized as BL in the WHO Classification v3. This case showed strong BCL2 staining, otherwise exhibiting features of BL. The case was treated with intensive chemotherapy containing high-dose methotrexate, cyclophosphamide, and cytarabine. However, soon after the chemotherapy, the lymphoma relapsed in the central nervous system and was resistant to whole-brain radiation therapy and allogeneic stem cell transplantation. The patient died 37 days after the transplantation. The clinical course was different from that of typical BL in terms of resistance to intensive chemotherapy, in agreement with the characteristics of iDLBCL/BL.
authors.affiliation: Department of Hematology, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Ibaraki, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Kurita
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Nishikii
authors.forename: Rie
authors.initials: R
authors.lastname: Nakamoto
authors.forename: Naoya
authors.initials: N
authors.lastname: Nakamura
authors.forename: Yuzuru
authors.initials: Y
authors.lastname: Kondo
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Okoshi
authors.forename: Kazumi
authors.initials: K
authors.lastname: Suzukawa
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Hasegawa
authors.forename: Yasuhisa
authors.initials: Y
authors.lastname: Yokoyama
authors.forename: Masayuki
authors.initials: M
authors.lastname: Noguchi
authors.forename: Shigeru
authors.initials: S
authors.lastname: Chiba
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002051:Burkitt Lymphoma / Q000235:genetics / Q000473:pathology; D003520:Cyclophosphamide / Q000008:administration & dosage; D003561:Cytarabine / Q000008:administration & dosage; D017809:Fatal Outcome; D006801:Humans; D016393:Lymphoma, B-Cell / Q000188:drug therapy* / Q000235:genetics* / Q000473:pathology*; D016403:Lymphoma, Large B-Cell, Diffuse / Q000235:genetics / Q000473:pathology; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000096:biosynthesis* / Q000235:genetics
chemical_list: D019253:Proto-Oncogene Proteins c-bcl-2; D003561:Cytarabine; D003520:Cyclophosphamide; D008727:Methotrexate