An Anecdotal Case Report of Chronic Lymphatic Leukemia with del(11q) Treated with Ibrutinib: Artificial Nourishment and Physical Activity Program

Abstract

Chronic lymphatic leukemia (CLL) is the most frequent type of leukemia in western countries and when association with del(11q) is correlated with a worse prognosis. We reported the clinical case of an 80-year-old patient with CLL related to del(11q) and a BMI of 16.4 kg/m2, who presented a voluminous mass in abdominal cavity (23 × 14 × 4 cm) which occupied the whole of the mesentery and the retroperitoneal space, treated with ibrutinib, adequate nutrition, and a program of physical activity. He showed a great improvement under ibrutinib therapy and took to artificial nourishment and adequate muscle rehabilitation until he recovered his autonomy. In August 2018, a 5-days-a-week training program was started: Physical activity for at least 20 min consisting of a fast walk in the open air three times a week and a moderate physical activity in the remaining two days of at least 20 consecutive minutes (cycling at a regular pace, carrying light weights). The exercise program included also aerobic, upper and lower limb resistance training, chore stability and stretches. The physical condition further improved and remained excellent throughout the follow-up period. In December 2018, his clinical condition was quite normal; a CT showed a great decrease of all lymphoadenomegaly, and FISH test did not show del(11q). He continued to cultivate his land, while still being treated with ibrutinib. The combination of the right therapy, adequate nutrition, and muscle rehabilitation is the best solution to improve the clinical condition of old cachectic CLL del(11q) patient.

The impact of the SARS‐CoV‐2 infection, with special reference to the hematological setting

“…The study showed that patients with hematologic cancers had a similar rate of SARS‐CoV‐2 infection as that of health care providers, but, once infected, they presented a more serious disease and a significantly higher mortality rate 5 . These example data, together with the data from few small other studies, suggest that the exposure of patients with cancer to SARS‐CoV‐2 is very risky, and that every possible precaution must be put in place to prevent this from happening 6‐12 . These considerations also apply to the context of bone marrow transplantation 13‐15…”

“…5 These example data, together with the data from few small other studies, suggest that the exposure of patients with cancer to SARS-CoV-2 is very risky, and that every possible precaution must be put in place to prevent this from happening. [6][7][8][9][10][11][12] These considerations also apply to the context of bone marrow transplantation. [13][14][15] We have prepared this review article for all doctors who have not had the opportunity to investigate the different aspects of COVID-19 sufficiently, including young infectious disease specialists, hematologists, and general practitioners, who for more than one reason may meet patients with COVID-19, having to make a first diagnosis and the first decisions about it.…”

How Fear of COVID-19 Can Affect Treatment Choices for Anaplastic Large Cell Lymphomas ALK+ Therapy: A Case Report

“…After two relapses, our patient achieved complete remission of the disease with brentuximab used as a third-line therapy. According to international guidelines, patients with ALCL ALK +, once a CR at a rescue therapy has been obtained, must undergo allo-SCT, which could have a high chance of success [ 31 , 32 , 33 , 34 , 35 ]. The young age of the patient and her refractory to the first- and second-line treatments prompted us to proceed toward allo-SCT, so far without success, due to the unsuitability of the contacted donors [ 36 , 37 , 38 , 39 ].…”

Rescue Therapy of Refractory Diffuse Large B-Cell Lymphomas BCL2 with Venetoclax: Case Report

“…This effect is further strengthened by the expression of MYC (“double-expresser” lymphoma; DE) and by the translocations of both the MYC and BCL2 genes (double-stroke lymphoma). This has been the most coveted therapeutic targets for all B-cell cancers until venetoclax, the first selective inhibitor of the BCL2, has been marketed [5, 6]. This drug is administered orally and has indications in the USA, Europe, and some other countries to treat adults with chronic lymphatic leukaemia, with or without 17p deletion, who have failed at least 1 previous treatment.…”