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