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