Single-agent MOR208 salvage and maintenance therapy in a patient with refractory-relapsing diffuse large B-cell lymphoma: a case reportReportar como inadecuado




Single-agent MOR208 salvage and maintenance therapy in a patient with refractory-relapsing diffuse large B-cell lymphoma: a case report - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

Journal of Medical Case Reports

, 10:123

First Online: 14 May 2016Received: 06 August 2015Accepted: 18 March 2016DOI: 10.1186-s13256-016-0875-x

Cite this article as: Jurczak, W., Bryk, A.H., Mensah, P. et al. J Med Case Reports 2016 10: 123. doi:10.1186-s13256-016-0875-x

Abstract

BackgroundDiffuse large B-cell lymphoma is the most common subtype of non-Hodgkin’s lymphoma. Standard first-line treatment for this aggressive subtype comprises the anti-CD20 antibody rituximab combined with cyclophosphamide, doxorubicin, vincristine, and prednisone. If patients receiving such treatment have an early relapse, or their disease is initially refractory to such treatment, standard salvage regimens may not be effective. There is therefore a high unmet clinical need for new targeted agents that might improve the outcome for such patients. CD19 is a B-lymphocyte lineage-specific cell surface antigen that is expressed by most B-cell non-Hodgkin’s lymphomas. MOR208 is an fragment-crystallizable engineered humanized monoclonal antibody with enhanced antitumor activity that targets CD19 and that may consequently have clinical utility in this setting.

Case presentationWe describe the case of a 33-year-old Caucasian man who presented with a 3-month history of general symptoms and who was admitted to our pulmonology ward with dyspnea due to pneumonia and severe anemia. A histopathological examination of an enlarged right suprasternal lymph node confirmed a diagnosis of T-cell-histiocyte-rich large B-cell lymphoma, an uncommon morphological variant of diffuse large B-cell lymphoma. Our patient had a complete response to first-line rituximab combined with cyclophosphamide, doxorubicin, vincristine, and prednisone, but had an early relapse 5 months after the end of treatment. After intensive salvage therapy consolidated with an autologous stem-cell transplant, our patient again had an early relapse and was subsequently enrolled in a phase IIa trial of single-agent MOR208. Following a scheduled 3 months of weekly treatment, a partial response was confirmed and MOR208 was continued as maintenance therapy, with administration every second week. Positron emission tomography-computed tomography confirmed a complete response 9 months later. This response is ongoing, with a duration of 24 months. MOR208 was well-tolerated by our patient and his quality of life and performance status remain high. No hospitalizations were required and our patient engaged in full-time work and physical activities.

ConclusionThird-line single-agent therapy with the CD19 antibody MOR208 was highly effective in this patient, despite a history of early relapse after standard first-line and second-line treatment regimens. These data provide support for future randomized studies of MOR208.

KeywordsDLBCL CD19 MOR208 MOR00208 XmAb5574 AbbreviationsABCactivated B-cell

ASCTautologous stem-cell transplant

BEAMcarmustine, etoposide, cytarabine, and melphalan

CLLchronic lymphocytic leukemia

CNScentral nervous system

CRcomplete response

CTcomputed tomography

Dday

DLBCLdiffuse large B-cell lymphoma

G-CSFgranulocyte-colony stimulating factor

HandEhematoxylin and eosin

IPIInternational Prognostic Index

MBPSmediastinum blood pool structure

NHLnon-Hodgkin’s lymphoma

PETpositron emission tomography

PRpartial response

R-CHOPrituximab with cyclophosphamide, doxorubicin, vincristine, and prednisone

SLLsmall lymphocytic lymphoma

SUVstandard uptake value

TEAEtreatment-emergent adverse event

THRLBCLT-cell-histiocyte-rich large B-cell lymphoma

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Autor: Wojciech Jurczak - Agata Hanna Bryk - Patrycja Mensah - Krystyna Gałązka - Małgorzata Trofimiuk–Müldner - Łukasz Wyr

Fuente: https://link.springer.com/







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