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Correspondence to Author: Kanbar Jihad, 

Tawam Hospital, Oncology Department, Al-Ain, UAE.

Introduction: Mantle Cell Lymphoma, or MCL; RRVD stands for Rituximab, Revlimid, Velcade, and Dexamethasone; VBR stands for Rituximab, Bendamustine, and Velcade; CHOP: Vincristine, Hydroxydaunorubicin, Cyclophosphamide, and PrednisoneMature B cell lymphomas are the ones that include the classical type of Mantle cell lymphoma (MCL). It is comparatively rare, accounting for 7-8% of cases of NHL (non-Hodgkins lymphoma). The majority of patients present with advanced cases, having a median age of 68 years at presentation [1]. The hallmark of MCL is the presence of translocation (11; 14) (q13; q32), which results in Cyclin D1 expression that is dysregulated. The patient’s age and level of fitness determine the course of the first therapy. Usually, rituximab-based chemoimmunotherapy is used first, and if clinically appropriate, auto HSCT comes next. Recently, the median survival increased from three years to five to seven years [2, 3].

CASE PRESENTATION

On December 11, 2008, a lung biopsy revealed the presence of pulmonary tuberculosis in a 63-year-old patient. He began using anti-tuberculosis (ATT) drugs and completed a full year of ATT treatment. In November 2010, during a follow-up visit at the pulmonary clinic, it was discovered that he had left submandibular lymphemia. ENT was recommended for him. At first, his FNAC revealed unusual cells. On 2/1/2011, he underwent an excisional biopsy. The results of the biopsy were MCL. In February 2011, the patient was sent to the hematology/ oncology service. He underwent a heart function examination, bone marrow biopsy, and staging work-up. With a MIPI score of 7.4 (high risk disease), he was classified as stage IIIA. He had CHOPR treatment when it was decided he wasn’t fit for the high CVAD procedure.He was treated with CHOPR for six cycles with intrathecal prophylaxis when it was determined that he was not suited for the high CVAD regimen. He had repeated admissions for neutropenic fever due to his poor treatment tolerance. June 2011 marked the end of his six chemotherapy rounds. Following four cycles, a CT scan revealed partial response (PR).When it was found that he was not a good candidate for the high CVAD regimen, he had intrathecal prophylaxis along with six cycles of CHOPR treatment. As a result of his poor treatment tolerance, he was repeatedly admitted with neutropenic fever. He finished his six rounds of chemotherapy in June 2011. A partial response (PR) was observed after four cycles, with a mixed response and notable development of LNs in the mediastinum, according to a CT scan.He was moved on Rituximab, Lenalidomide, Velcade, and Dexamethasone (3rd line therapy) (RRVD).

Citation:

Kanbar Jihad. Mantle Cell Lymphoma with Relapse: A Case Report and Literature Review. The Journal of Clinical Oncology 2024.