Successful Use of Bortezomib–Lenalidomide Combination as Treatment for a Patient With Plasmablastic Lymphoma

Marrero, William; Cruz-Chacón, Alexis; Castillo, Christian E; Cabanillas, Fernando

doi:10.1016/j.clml.2018.04.011

Cited by 13 publications

(10 citation statements)

References 17 publications

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“…The patient received two cycles of the protocol only which was discontinued due to developing pancreatitis attributed to bortezomib. PET CT scan performed after the two cycles showed no evidence of disease and the patient remained in complete remission for at least 12 months from the onset of the salvage therapy [ 52 ].…”

Section: Discussionmentioning

confidence: 99%

Bortezomib, Lenalidomide and Dexamethasone Combination Induced Complete Remission in Relapsed/Refractory Plasmablastic Lymphoma: Case Report of a Potential Novel Treatment Approach

Sabry

Kodad

2022

Current Oncology

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Plasmablastic lymphoma is a rare subtype of large B-cell lymphoma characterised by an aggressive clinical course with frequent relapses and refractoriness to chemotherapy. It is usually associated with HIV, however, it can also be seen in immunocompetent patients. It has distinct pathological characteristics, such as plasmablastic morphology and lack of CD20 expression. These characteristics pose a clinical and pathological challenge. There is no standard of care established in this entity. In this case report, we described a novel bortezomib-based plasma cell targeted regimen in a HIV-negative patient refractory to chemotherapy.

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Section: Discussionmentioning

confidence: 99%

Bortezomib, Lenalidomide and Dexamethasone Combination Induced Complete Remission in Relapsed/Refractory Plasmablastic Lymphoma: Case Report of a Potential Novel Treatment Approach

Sabry

Kodad

2022

Current Oncology

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“…Also of note in the frontline setting, the three patients (60%) who achieved complete response had received bortezomib as part of CYBORD (cyclophosphamide, bortezomib, and dexamethasone) or in combination with EPOCH. A recently published case report of PBL involving the right parotid gland in a HIV-negative patient showed continuous complete remission at 12 months using bortezomib plus lenalidomide upon relapse after CHOP [14]. Another case report of HIV-negative PBL utilizing a lenalidomide-based regimen with complete remission at 24 months suggests its usage as an alternative therapy for patients unable to tolerate intensive chemotherapy [8].…”

Section: Discussionmentioning

confidence: 99%

A Rare Presentation of HIV-Negative Plasmablastic Lymphoma: A Diagnostic Dilemma

Kessler

Marcellino

Niglio

et al. 2019

Case Reports in Hematology

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Plasmablastic lymphoma (PBL) and plasmablastic plasma cell myeloma (PCM) have many overlapping characteristics. Clinical correlation can help make the distinction between the two entities. Human immunodeficiency virus- (HIV-) negative PBL is a rare disease, making the diagnosis more challenging. While there is no standard of care for PBL, current recommendations include dose-adjusted EPOCH (etoposide, vincristine, doxorubicin, cyclophosphamide, and prednisone), with or without bortezomib. We report an aggressive case of HIV-negative plasmablastic lymphoma and discuss the challenge in establishing a diagnosis. We review the literature regarding this disease and current recommendations for treatment.

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“…Either solely [27] or in combination with lenalidomide [26], brentuximab vedotin has demonstrated a very rapid response with significant reduction in the tumor sizes [26, 27]. Lenalidomide has also shown similar results in a few reported cases [26, 28, 29]. In a study of 82 PBL patients, Laurent et al showed immune checkpoint expression (PD1/PD-L1) in the tumor microenvironment in the majority of cases and about 25% of the tumor cells expressed PD-L1.…”

Section: Discussionmentioning

confidence: 99%

Plasmablastic Lymphoma, a Rare Entity in Bone Marrow with Unusual Immunophenotype and Challenging Differential Diagnosis

Shaarani

Shackelford

Master

et al. 2019

Case Reports in Hematology

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Plasmablastic lymphoma (PBL) is an aggressive malignancy that usually occurs in the setting of immunosuppression. The immunohistochemical profile of PBL is that of terminally differentiated B lymphocytes. CD138, CD38, and MUM1 are usually immunopositive. However, pan B-cell markers such as CD20 and PAX-5 are usually negative.MYCrearrangement is the most commonly encountered genetic alteration, with immunoglobulin (IG), especially immunoglobulin heavy (IGH) chain, being the most frequent partner. We report a case of PBL in a 48-year-old human immunodeficiency virus- (HIV-) positive male who was admitted to the hospital with signs and symptoms suspicious for tumor lysis syndrome. Bone marrow examination revealed hypercellular marrow with trilineage hypoplasia and sheets of intermediate to large neoplastic cells with basophilic vacuolated cytoplasm comprising the majority of cellular elements of the bone marrow. The neoplastic cells were negative for conventional B-cell, T-cell, plasma cell, and myeloid markers, while flow cytometric analysis revealed an abnormal CD45-dim population that was partially weakly positive for CD71 and CD79b. The diagnosis was initially thought to be a high-grade primitive hematopoietic neoplasm, possibly an acute undifferentiated leukemia. BOB-1, however, was immunopositive in the neoplastic cells, confirming its B-cell origin. MYC was positive by immunohistochemistry and break-apart FISH, as were CD45, MUM-1, and EMA immunostains. There was immunoglobulin kappa (IGK) light chain gene rearrangement by polymerase chain reaction (PCR). Additionally, Epstein–Barr virus- (EBV–) encoded small RNAs (EBER) were positive by in situ hybridization (ISH). The tumor proliferation index by Ki-67 immunostaining approached 95%. Although the tumor cells were negative for CD38 and CD138, the diagnosis of PBL was still rendered. We recommend using a broad spectrum of B-cell markers, including BOB-1 and OCT-2, in such challenging cases of B-cell lymphomas with no expression of conventional B-cell markers. We also emphasize that the negative CD38 and CD138 should not exclude PBL from the differential diagnosis.

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Successful Use of Bortezomib–Lenalidomide Combination as Treatment for a Patient With Plasmablastic Lymphoma

Cited by 13 publications

References 17 publications

Bortezomib, Lenalidomide and Dexamethasone Combination Induced Complete Remission in Relapsed/Refractory Plasmablastic Lymphoma: Case Report of a Potential Novel Treatment Approach

Bortezomib, Lenalidomide and Dexamethasone Combination Induced Complete Remission in Relapsed/Refractory Plasmablastic Lymphoma: Case Report of a Potential Novel Treatment Approach

A Rare Presentation of HIV-Negative Plasmablastic Lymphoma: A Diagnostic Dilemma

Plasmablastic Lymphoma, a Rare Entity in Bone Marrow with Unusual Immunophenotype and Challenging Differential Diagnosis

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