Excessive-dose chemotherapy with autologous stem cell transplantation following systemic chemotherapy, prophylactic intrathecal methotrexate, and radiotherapy prevents relapse and improves the end result of superior stage major testicular lymphoma even with cardiac involvement.
J Clin Exp Hematop. 2017 Oct 12;57(2):64-68
Authors: Lee S, Yamauchi T, Kinoshita Okay, Imamura S, Kamiya Okay
Major testicular lymphoma (PTL) is a uncommon however aggressive illness. Though most sufferers current within the early stage, their prognosis is poor. Comparable with PTL, cardiac lymphoma can be an unusual illness characterised by its aggressive medical course and poor prognosis. We herein report an especially uncommon case of superior stage PTL with cardiac involvement, handled by high-dose chemotherapy with autologous stem cell transplantation (HDT-ASCT) adopted by systemic chemotherapy, prophylactic intrathecal methotrexate (IT-MTX), and radiotherapy. A 48-year-old man introduced with painless left scrotal swelling. He was recognized with PTL after orchiectomy, and the histological kind was diffuse giant B-cell lymphoma. For staging of lymphoma, positron emission tomography was carried out, which revealed uptake in the best atrium and early cardiac metastasis inside simply 2 months after orchiectomy. He underwent 6 cycles of systemic chemotherapy that consisted of rituximab, doxorubicin, cyclophosphamide, vincristine, and prednisolone (R-CHOP). He additionally obtained central nervous system prophylaxis four occasions with weekly IT-MTX throughout the first 2 cycles of R-CHOP. He achieved full response after 6 cycles of R-CHOP, and underwent HDT-ASCT and radiotherapy as consolidation remedy with out irreversible hostile results. He’s at present doing properly, with a progression-free survival of 31 months. The above remedy technique together with HDT-ASCT could also be one of many remedy choices for superior stage PTL with cardiac metastasis in sufferers youthful than 65 years outdated.
PMID: 28883219 [PubMed – indexed for MEDLINE]