A Rare Case of Grey Zone Lymphoma Successfully Treated with Brentuximab Vedotin and R-CHP Chemotherapy

Introduction. The diagnosis of B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma (DLBCL) and classical Hodgkin’s lymphoma (cHL), also referred to as grey zone lymphoma (GZL), is a challenging diagnosis. There are no standardized guidelines; however, ev...

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Published inCase reports in oncological medicine Vol. 2019; no. 2019; pp. 1 - 4
Main Authors Leslie, Lori A., Shenoy, Vishnu A., Alquran, Lance, Mallipudi, Rajiv M., Conti, John A.
Format Journal Article
LanguageEnglish
Published Cairo, Egypt Hindawi Publishing Corporation 01.01.2019
Hindawi
Hindawi Limited
Wiley
Subjects
Anthracyclines
Biological products
Biopsy
Bone marrow
Brentuximab vedotin
Cancer
Care and treatment
Case Report
Case reports
Chemotherapy
Corticosteroids
Cyclophosphamide
Hematology
Immunotherapy
Lymphatic system
Lymphoma
Mammography
Medical imaging
Monoclonal antibodies
Morphology
Non-Hodgkin's lymphomas
Prednisone
T cells
Targeted cancer therapy
Vincristine
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Summary:Introduction. The diagnosis of B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma (DLBCL) and classical Hodgkin’s lymphoma (cHL), also referred to as grey zone lymphoma (GZL), is a challenging diagnosis. There are no standardized guidelines; however, evidence strongly suggests that DLBCL-based regimens are effective in the treatment of GZL. Brentuximab vedotin (BV) is an anti-CD30 antibody drug conjugate that has established efficacy in relapsed/refractory Hodgkin and some T-cell lymphomas. There is some evidence that BV has a positive response in non-Hodgkin lymphoma (NHL) with a wide range of CD30 expressions—including GZL. Case. We present a case of a patient initially diagnosed with cHL who underwent repeat biopsy which was revealed to be GZL. Based on PET scanning and immunohistochemical studies, she was classified as a stage IIIA CD20+/CD30+ GZL patient. Given her strong CD30 expression, she underwent 6 cycles of R-BV-CHP (rituximab, brentuximab vedotin, cyclophosphamide, doxorubicin, and prednisone) chemotherapy and achieved complete response (CR) both clinically and radiographically. Discussion. Given the rarity of GZL, this case illustrates the immense challenges in making the diagnosis, discusses the current treatment options, and suggests that BV may be a viable therapeutic candidate in the treatment of GZL.
Bibliography:Academic Editor: Josep M. Ribera
ISSN:2090-6706
2090-6714
DOI:10.1155/2019/4121234