Immunochemotherapy for Bcl-2 and MUM-negative aggressive primary cutaneous B-cell non-Hodgkin’s lymphoma

Abstract

The case of a 44-year-old man with a primary cutaneous large B-cell non-Hodgkin's lymphoma of the scalp is reported. His mother died of gastric lymphoma and his sib brother is in a 20-year remission of T-cell lymphoma. The patient presented with a 16-year history of occipital and parietal alopecia and a recently worsening scalp rash. The histopathology and immunohistochemistry performed in April 2006 indicated a bcl-6+, MUM- and bcl-2-, primary cutaneous follicle center B-cell non-Hodgkin's lymphoma, with an aggressive transformation to a diffuse large B-cell lymphoma. Bone marrow biopsy and CT chest, abdomen, and pelvis were negative for systemic lymphoma. The patient had an excellent clinical and histological resolution following 8 cycles of rituximab and CHOP protocol immunochemotherapy, and remains in complete remission until now. The protracted indolent phase of the disease, the familial history of lymphoma, the histological aggressive features and the patient's excellent response to immunochemotherapy all contribute to a very unusual manifestation of this disease.

Primary gastric non-Hodgkin's lymphoma in Chinese patients: clinical characteristics and prognostic factors

“…Rituximab, a chimeric anti-CD20 antibody, was found to be effective in terms of improving survival rate as well as eliciting an effective clinical response when used in combination with conventional chemotherapy for various subtypes of B-cell lymphoma patients [24-26]. As far as we know, there were no previous studies directly compared immunotherapy-chemotherapy with chemotherapy alone in PGL.…”

Intravascular large B-cell lymphoma with prominent cutaneous manifestation — case report

“…Patients with isolated "cutaneous variant" are mostly females of younger age with good performance status, normal leukocyte and platelet counts and have a better survival rate than patients with other clinical presentations (3 -yr survival 56%) [4,10]. The most effective treatment seems to be the combination Intravascular large B-cell lymphoma with prominent cutaneous manifestation of chemotherapy (CHOP) with the anti-CD20 antibody rituximab, as all tumour cells express the CD20 antigen [11,12]. Shimada K et al showed that progression-free survival (PFS) and overall survival (OS) at 2 years in patients receiving chemotherapy with rituximab were 56% and 66% respectively.…”

Concurrent thrombotic thrombocytopenic purpura and immune thrombocytopenic purpura in a patient with metastatic neuroendocrine tumour successfully treated with rituximab-CVP

“…This agent has been used in the treatment of rheumatoid arthritis, systemic lupus erythematosus, ITP, multiple sclerosis, autoimmune haemolytic anaemia, TTP, graft versus host disease, clotting factor inhibitor, Graves’ disease and B-cell lymphomas 20–23. Successful in the treatment of haematological autoimmune disorders, rituximab is only mildly toxic in comparison to combination chemotherapy, which may yield more side effects.…”