Can early switch to rituximab-bendamustine in a patient with follicular non-Hodgkin lymphoma progressing during R-CHOP be considered frontline treatment? A case report

Claudio Cerchione, Davide Nappi, Gerardo Musuraca, Alessandro Lucchesi, Ilaria Cimmino, Fabrizio Pane, Amalia De Renzo, Giovanni Martinelli

Research output: Contribution to journalArticlepeer-review

Abstract

RATIONALE: Follicular non-Hodgkin lymphoma (fNHL) is a neoplasm characterized by an indolent course and chemosensitivity, but also by disease recurrence. Bendamustine is often used as frontline treatment or second line. HEADING DIAGNOSIS:: fNHL.

PATIENT CONCERNS: A 63-year-old Caucasian male with diagnosis of fNHL lymphoma underwent to cyclophosphamide, doxorubicin, vincristine, and prednisone associated with rituximab chemoimmunotherapy, during which interim reevaluation showed progressive disease and severe toxicity.

INTERVENTIONS: Early switch to rituximab-bendamustine.

OUTCOMES: This regimen was well tolerated, patient compliance was optimal, there were no delays in administration and no infectious episodes. An interim reevaluation after 3 courses revealed that the patient was fit, the blood cell count was normal, and lymphadenopathies and nocturnal sweating had completely regressed. Of note, the PET/CT scan did not show fluorodeoxyglucose pathological uptake, clearly confirming disease regression.

LESSONS: Early switching to a bendamustine-rituximab-based scheme, even during conventional chemotherapy, decreases toxicity and reduces the risk of treatment interruption or delay, with favorable effects on overall response and prognosis.

Original languageEnglish
Pages (from-to)e21440
JournalMedicine
Volume99
Issue number33
DOIs
Publication statusPublished - Aug 14 2020

Keywords

  • Antineoplastic Combined Chemotherapy Protocols
  • Bendamustine Hydrochloride/therapeutic use
  • Cyclophosphamide
  • Doxorubicin
  • Humans
  • Lymphoma, Follicular/drug therapy
  • Male
  • Middle Aged
  • Prednisone
  • Rituximab/therapeutic use
  • Vincristine

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