Abstract
High-grade B-cell lymphoma with MYC and BCL2 and/or BCL6 rearrangements, also known as double-hit lymphoma, has been reported as refractory to R-CHOP therapy and requires more intensive regimens. However, intensive and safe regimens for patients with renal dysfunction are unknown. Herein, we report the successful use of DA-EPOCH-R therapy for double-hit lymphoma in a 64-year-old man with renal dysfunction. The patient had lymphoma-induced bilateral ureteral obstruction. Although renal dysfunction remained after removing the obstruction using R-CHOP therapy, we completed six cycles of DA-EPOCH-R therapy without any major adverse events. DA-EPOCH-R therapy may be a safe regimen for renal dysfunction patients.
Keywords:
DA-EPOCH-R therapy; double-hit lymphoma; high-grade B-cell lymphoma with MYC and BCL2 and/or BCL6 rearrangements; renal dysfunction; renal impairment.
MeSH terms
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Antineoplastic Combined Chemotherapy Protocols / adverse effects
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Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
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Biomarkers
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Biomarkers, Tumor
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Biopsy
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Cyclophosphamide / adverse effects
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Cyclophosphamide / therapeutic use
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Doxorubicin / adverse effects
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Doxorubicin / therapeutic use
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Etoposide / adverse effects
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Etoposide / therapeutic use
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Female
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Gene Rearrangement*
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Humans
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Immunohistochemistry
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In Situ Hybridization, Fluorescence
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Kidney Diseases / complications*
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Kidney Diseases / diagnosis
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Kidney Function Tests
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Lymphoma, B-Cell / complications
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Lymphoma, B-Cell / diagnosis
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Lymphoma, B-Cell / genetics*
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Lymphoma, B-Cell / therapy*
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Male
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Neoplasm Grading
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Neoplasm Staging
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Prednisone / adverse effects
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Prednisone / therapeutic use
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Proto-Oncogene Proteins c-bcl-2
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Proto-Oncogene Proteins c-bcl-6
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Proto-Oncogene Proteins c-myc / genetics
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Rituximab / administration & dosage
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Tomography, X-Ray Computed
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Treatment Outcome
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Vincristine / adverse effects
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Vincristine / therapeutic use
Substances
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BCL2 protein, human
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BCL6 protein, human
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Biomarkers
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Biomarkers, Tumor
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Proto-Oncogene Proteins c-bcl-2
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Proto-Oncogene Proteins c-bcl-6
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Proto-Oncogene Proteins c-myc
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Rituximab
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Vincristine
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Etoposide
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Doxorubicin
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Cyclophosphamide
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Prednisone