A 66-Year-Old Woman With Mantle Cell Lymphoma - Episode 1
Javier Munoz, MD, MS, FACP: I have been given the opportunity to discuss the case of a 66-year-old woman with mantle cell lymphoma. She was treated in 2017. She was treated with R-CHOP [rituximab cyclophosphamide, hydroxydaunorubicin hydrochloride, vincristine, prednisone] and R-DHAP [rituximab, dexamethasone, cytarabine, cisplatin], followed by autologous stem cell rescue, and she achieved a partial remission. She was subsequently prescribed rituximab maintenance. In 2019 she experienced a clinical relapse and was started on acalabrutinib, achieving stable disease.
Currently, she complains of a 3-month history of fatigue, nausea, and dyspnea. Her medical history includes having diabetes, which is medically well controlled. On physical exam, she has lymphadenopathy. Indeed, a new lymph node biopsy showed cyclin D1 positivity and CD10 and CD20 positivity, and the FISH [fluorescence in situ hybridization] showed the translocation of chromosomes 11 and 14. The imaging, not surprisingly, confirmed the physical findings of lymphadenopathy, widespread adenopathy above and below the diaphragm. A bone marrow biopsy confirmed that the patient had mantle cell lymphoma as well.
Treatment was started with lymphodepleting chemotherapy—fludarabine and cyclophosphamide—followed by a single infusion of CAR [chimeric antigen receptor] T cells.
Transcript edited for clarity.
Case: A 66-Year-Old Woman With Mantle Cell Lymphoma