Onkológia 6/2020

Third line treatment in a patient over 60 years of age with the refractory/relapsed aggressive B-non Hodgkin’s lymphoma type DLBCL

Introduction: Treatment of refractory/relapsed aggressive B-non Hodgkin’s lymphoma is problematic especially in elderly patients over 60 years of age and patients unsuitable for another treatment alternative, including high-dose chemotherapy with autologous hematopoietic transplantation. Achieving long-term remission is difficult and the prognosis is unfavorable. Purpose: Our aim was to achieve a long-term response to palliative care in the 3rd line treatment with the new aza-anthracenedione cytostatic pixantrone, prolonged patient survival and minimalized the symptoms of lymphoma. Case: At the time of diagnosis of aggressive B-non Hodgkin’s lymphoma type DLBCL in stage IV, the patient was 67 years old, with age associated comorbidity. In lymphoma refractory, the first two lines of treatment proved ineffective. The first long-term response was not observed until after the 3rd line with 6 cycles of pixantrone monotherapy. Despite the patient’s unfavorable prognosis PET-CT confirmed metabolic remission persisted for 12 months after the end of chemotherapy. Conclusion: In the case of elderly patient, we verified the efficacy and safety of a new available drug pixantrone in the 3rd line of palliative therapy of aggressive B-non Hodgkin’s lymphoma. Despite pretreatment, including anthracyclines, and the patient’s comorbidity, pixantrone allowed the first long-term metabolic remission to be achieved.

Keywords: refractory/relapsed aggressive B-non Hodgkin’s lymphoma, pixantrone, older patients