Journal of clinical practice and research · 2025
Experience of Using a Bruton Tyrosine Kinase (BTK) Inhibitor in Primary Testicular Diffuse Large B-Cell Lymphoma (DLBCL) with Isolated Central Nervous System (CNS) Metastasis.
Клинический случайСтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Meedimale Santhosh, Panda Soumya Surath, Panda Adya Kinkar, Mohapatra Debahuti, Bhola Rajesh Kumar, Moharana Lalatendu, Mohanty Swati Sucharita, Samantaray Lipsita
Аннотация
BACKGROUND: Primary testicular lymphoma (PTL) is a rare subtype of non-Hodgkin's lymphoma (NHL), most commonly presenting as diffuse large B-cell lymphoma (DLBCL). It primarily affects older men and has a tendency to relapse in the central nervous system (CNS), contralateral testis, and lungs. Although rituximab has improved survival outcomes, its limited CNS penetration is a clinical challenge.
CASE REPORT: We report the case of a 39-year-old man diagnosed with primary testicular DLBCL (PT-DLBCL) (triple expresser). He received six cycles of R-CHOP (rituximab, cyclophosphamide, doxorubicin (hydroxydaunorubicin), vincristine (oncovin), and prednisone) combined with high-dose methotrexate (HD-MTX) and contralateral testicular radiation. After 33 months of disease-free survival, he experienced a CNS relapse. He was subsequently treated with the MAR (methotrexate, cytarabine, and rituximab) regimen, consisting of HD-MTX, cytarabine (Ara-C), and rituximab. Following whole-brain radiotherapy and rituximab maintenance therapy, he achieved complete response and was transitioned to maintenance therapy with acalabrutinib.
CONCLUSION: This case highlights the successful use of the MAR regimen and acalabrutinib maintenance in a patient with CNS-relapse PT-DLBCL. Further studies are needed to develop standardized treatment protocols for such high-risk cases.
CASE REPORT: We report the case of a 39-year-old man diagnosed with primary testicular DLBCL (PT-DLBCL) (triple expresser). He received six cycles of R-CHOP (rituximab, cyclophosphamide, doxorubicin (hydroxydaunorubicin), vincristine (oncovin), and prednisone) combined with high-dose methotrexate (HD-MTX) and contralateral testicular radiation. After 33 months of disease-free survival, he experienced a CNS relapse. He was subsequently treated with the MAR (methotrexate, cytarabine, and rituximab) regimen, consisting of HD-MTX, cytarabine (Ara-C), and rituximab. Following whole-brain radiotherapy and rituximab maintenance therapy, he achieved complete response and was transitioned to maintenance therapy with acalabrutinib.
CONCLUSION: This case highlights the successful use of the MAR regimen and acalabrutinib maintenance in a patient with CNS-relapse PT-DLBCL. Further studies are needed to develop standardized treatment protocols for such high-risk cases.