TITLE:
Series of Low-Grade B-Cell Lymphoma: Follicular Lymphoma, Marginal Zone Lymphoma, Waldenstrom Macroglobulinemia and Mantle Cell Lymphoma
AUTHORS:
Ganesh Kasinathan
KEYWORDS:
Low-Grade B-Cell Lymphoma, Bone Marrow Involvement, Rituximab, Pleural Effusion
JOURNAL NAME:
Open Access Library Journal,
Vol.7 No.9,
September
23,
2020
ABSTRACT: Low grade B-cell non-Hodgkin lymphoma (LBNHL) is usually slow growing and most often incurable. Case 1: A 47-year-old Malay gentleman was diagnosed with relapsed Stage IV Grade 2 Follicular Lymphoma (Follicular lymphoma international prognostic index, FLIPI 2: intermediate risk). He was initially treated with 6 cycles of standard rituximab, cyclophosphamide, doxorubicin, vincristine and prednisolone (R-CHOP) polychemotherapy at first presentation and was in remission for 8 years until he relapsed with new inguinal lymphadenopathy and bone marrow involvement. He was re-treated with 6 cycles of rituximab-bendamustine (R-B), in which he is in complete remission for the past 2 years. Case 2: A 45-year old Malay female presented with previously untreated Stage IV extranodal marginal zone lymphoma of the left pleura with nodal and bone marrow involvement which did not respond adequately to 3 cycles of R-CHOP chemotherapy. Her unilateral pleural effusion was persistent, and she required re-treatment with 4 cycles R-B immunochemotherapy. She is now in complete remission for the past 18 months. Case 3: A 70-year old Malay gentleman was diagnosed with Waldenstrom macroglobulinemia without hyperviscosity syndrome. He was treated with 2 cycles of R-B immunochemotherapy. However, he developed worsening anemia. He was re-treated with 6 cycles of Bortezomib-Rituximab-Dexamethasone (B-R-D) immunochemotherapy, in which he is currently in complete remission for the past 16 months. Case 4: A 59-year-old Malay gentleman diagnosed with Stage IV non-TP53 mutated leukemic phase mantle cell lymphoma achieved complete remission after completing 6 cycles of intensive chemotherapy followed by consolidation autologous stem cell transplant.