title: [Bendamustine-rituximab therapy is effective for transformed follicular lymphoma with significant expression of p53].
abstract: We describe a patient with transformed follicular lymphoma(FL), expressing p53 but remaining in complete remission(CR) due to bendamustine-rituximab(BR)therapy. She was a 64-year-old female diagnosed with stage IV FL(grade 3A)in July 2007 when she was admitted with right lower abdominal pain and body weight loss. Colonoscopy revealed Bauhin' valve lymphoma of the terminal ileum, and computed tomography(CT)scan showed lymphadenopathy, involving the cervical, mediastinal para-aortic lymph nodes and right tonsil. She received chemotherapy with eight courses of CHOP therapy with rituximab and achieved CR. Two and a half years later, mediastinal lymph node swelling relapsed, and ibritumomab tiuxetan therapy induced the second CR. After ten months, however, a third relapse occurred as a submucosal tumor(SMT)of the stomach. Gastric SMT biopsy showed diffuse large B cell lymphoma(DLBCL)transformation with immunohistochemical expression of p53. Although gastric SMT disappeared after radiotherapy, which achieved the third CR, lymph node swelling was detected again in the para-aortic and-iliac artery lymph nodes in September 2011. Subsequently, she was treated with five courses of BR therapy, because bendamustine had been reported to be effective for p53 gene-deficient B cell neoplasms. The therapy was successful and achieved the fourth CR, demonstrating that BR therapy was effective for p53-expressing DLBCL.
authors.affiliation: Dept. of Gastroenterology and Hematology/Clinical Oncology, Internal Medicine, Steel Memorial Muroran Hospital.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kuroda
authors.forename: Wataru
authors.initials: W
authors.lastname: Jomen
authors.forename: Shogo
authors.initials: S
authors.lastname: Miura
authors.forename: Yohei
authors.initials: Y
authors.lastname: Arihara
authors.forename: Michiko
authors.initials: M
authors.lastname: Yamada
authors.forename: Tasuku
authors.initials: T
authors.lastname: Hirako
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Abe
authors.forename: Tamaki
authors.initials: T
authors.lastname: Sakurai
authors.forename: Shigeyuki
authors.initials: S
authors.lastname: Fujii
authors.forename: Masahiro
authors.initials: M
authors.lastname: Maeda
authors.forename: Miri
authors.initials: M
authors.lastname: Fujita
authors.forename: Kazuo
authors.initials: K
authors.lastname: Nagashima
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Okagawa
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Hoki
authors.forename: Junji
authors.initials: J
authors.lastname: Kato
mesh_terms: D000368:Aged; D058846:Antibodies, Monoclonal, Murine-Derived / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D000069461:Bendamustine Hydrochloride; D005260:Female; D006801:Humans; D008224:Lymphoma, Follicular / Q000737:chemistry / Q000188:drug therapy* / Q000473:pathology; D008875:Middle Aged; D009367:Neoplasm Staging; D009588:Nitrogen Mustard Compounds / Q000008:administration & dosage; D012008:Recurrence; D000069283:Rituximab; D016159:Tumor Suppressor Protein p53 / Q000032:analysis*
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D009588:Nitrogen Mustard Compounds; C495901:TP53 protein, human; D016159:Tumor Suppressor Protein p53; D000069283:Rituximab; D000069461:Bendamustine Hydrochloride