A 74-Year-Old Man With Diffuse Large B-Cell Lymphoma
Gilles Salles, MD, reviews the case of a 74-year-old man with diffuse large B-cell lymphoma.
Case: A 74-Year-Old Man with Diffuse Large B-Cell Lymphoma
Initial Presentation
- A 74-year-old man presented with fever, 14-lb unintentional weight loss and occasional chest pain
- PMH: DM, medically controlled
- PE: tired-appearing man; palpable bilateral cervical lymphadenopathy
Clinical Work-up
- Labs: LDH 2 times above normal; Hb 10.8 g/dL; bilirubin 2.3 mg/dL; creatinine 1.7 mg/fl; all others WNL
- Hepatitis B, C and HIV negative
- Lymph node biopsy; CD 20+ confirmed DLBCL; IHC panel: CD 10+, CD 19+
- Imaging:
- Whole body PET/CT scan showed activity the cervical lymph node region, largest node 2.5 cm; evidence of axillary and thoracic subcutaneous tissue involvement
- Ann Arbor stage 4; IPI: high-risk; ECOG PS 1
Treatment
- Treatment initiated with R-CHOP + RT; well-tolerated
- Interim PET scan after 4 cycles; progressive diseases noted
- Due to transplant ineligibility patient was treated with tafasitamab + lenalidomide
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