Abstract YO21
Case summary
We are presenting a thirty-eight year old man who, presented with neck nodes, axillary nodes, altered sensorium, abnormal body movements, unconsciousness, weight loss and, fever, with a past history of DLBCL in May 2008, treated with 6 cycles of CHOP and completed in November 2008. After 9 years in April 2018, the patient developed similar symptoms and treated with salvage chemotherapy with R-DHAP which was completed in September 2018. Post-treatment PET-CT showed partial metabolic response. After completion of radiotherapy to bulky disease, the patient was very reluctant for any type of therapy and went home. After one month he presented to us with persistent vomiting, abnormal body movements and, altered sensorium. On examination, his GCS was E2V3M2 and was managed with mannitol, dexamethasone, antiepileptics, antibiotics and other supportive care medicines. His brain MRI was showing multiple heterogeneously enhancing lesions & his CSF analysis was positive for malignant cells. He was managed with triple intrathecal chemotherapy with methotrexate 12mg, Cytarabine 50mg, and Hydrocortisone 50mg, & after 4-5 days he regained consciousness & was able to talk and understand verbal commands. In view of improvement in GCS & PS, we started biweekly triple intra-thecal therapy, and Inj. Nivolumab 3 mg per kg q 2 weekly. From the second cycle, we started Lenalidomide 10mg once a day for 21 days with 7 days gap along with 2 weekly nivolumab and biweekly triple IT. After one month his CSF analysis was negative for malignant cells. Now he is on regular treatment with weekly IT chemotherapy, 2 weekly nivolumab and 3 weeks on and one week off lenalidomide. After 2 months of treatment, his MRI Brain was normal. At the time of submission of this article, he has completed the 10 cycle of immunotherapy and 5 cycles of lenalidomide. Patient tolerated immunotherapy, triple IT therapy and lenalidomide very well without much intolerable side effects. Therefore, we concluded that nivolumab and lenalidomide was well tolerated and exhibited antitumor activity in extensively pretreated patients with relapsed or refractory sanctuary site CNS B- cell lymphomas. Additional studies of Nivolumab and lenalidomide in these diseases are ongoing.
Clinical trial identification
Editorial acknowledgement
Resources from the same session
4P - Impact of chemotherapy and radiotherapy on tissue expander or implant removal in breast cancer patients
Presenter: Sungmi Jung
Session: Poster display session
Resources:
Abstract
5P - Long-term prognostic effect of hormone receptor subtype on breast cancer
Presenter: Ki-tae Hwang
Session: Poster display session
Resources:
Abstract
6P - Effect of apparent diffusion coefficient in predicting pathologic responses in patients with breast cancer treated with neoadjuvant chemotherapy using nanoparticle albumin-bound paclitaxel
Presenter: Yutaka Mizuno
Session: Poster display session
Resources:
Abstract
7P - Current diagnostic strategy for mammographic microcalcification without specific ultrasound abnormality
Presenter: Naoki Sato
Session: Poster display session
Resources:
Abstract
8P - Comparison of standard uptake value of 18F-FDG-PET-CT with tumour-infiltrating lymphocytes in breast cancer ≥1cm
Presenter: Soeun Park
Session: Poster display session
Resources:
Abstract
10P - Prognosis and effect of adjuvant treatment in small, node(-), HER2(+) breast cancer
Presenter: Seungtaek Lim
Session: Poster display session
Resources:
Abstract
11P - The prognosis of rare histopathologic subtype of breast cancer
Presenter: Soo Youn Bae
Session: Poster display session
Resources:
Abstract
12P - Daily collection of physical activity via smartphone application and smart band for development of distress screening tools in breast cancer survivors: A feasibility study
Presenter: Yungil Shin
Session: Poster display session
Resources:
Abstract
13P - Breast cancer distribution in East Azerbaijan, Iran: Results of population-based cancer registry
Presenter: Shima Pashaei
Session: Poster display session
Resources:
Abstract
14P - Validation of the optimum timing of assessment of tumour infiltrating lymphocytes during preoperative chemotherapy for breast cancer
Presenter: Shinichiro Kashiwagi
Session: Poster display session
Resources:
Abstract