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Relapsed/refractory diffuse large B cell lymphoma with cardiac involvement: A case report and literature review

BACKGROUND: Hematological malignancies of the heart (CHMs) are extremely rare, and include leukemia, lymphoma infiltration, and multiple myeloma with extramedullary manifestations. Cardiac lymphoma can be divided into primary cardiac lymphoma (PCL) and secondary cardiac lymphoma (SCL). Compared to P...

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Autores principales: Yang, Yuanyuan, Li, Zixuan, Li, Yuntao, Zhao, Yue, Shi, Mingxia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9923120/
https://www.ncbi.nlm.nih.gov/pubmed/36793603
http://dx.doi.org/10.3389/fonc.2023.1091074
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author Yang, Yuanyuan
Li, Zixuan
Li, Yuntao
Zhao, Yue
Shi, Mingxia
author_facet Yang, Yuanyuan
Li, Zixuan
Li, Yuntao
Zhao, Yue
Shi, Mingxia
author_sort Yang, Yuanyuan
collection PubMed
description BACKGROUND: Hematological malignancies of the heart (CHMs) are extremely rare, and include leukemia, lymphoma infiltration, and multiple myeloma with extramedullary manifestations. Cardiac lymphoma can be divided into primary cardiac lymphoma (PCL) and secondary cardiac lymphoma (SCL). Compared to PCL, SCL is relatively more common. Histologically, the most frequent SCL is diffuse large B-cell lymphoma (DLBCL). The prognosis of lymphoma in patients with cardiac involvement is extremely poor. CAR T-cell immunotherapy has been recently become a highly effective treatment for relapsed or refractory diffuse large B-cell lymphoma. To date, there are no guidelines that provide a clear consensus on the management of patients with secondary heart or pericardial involvement. We report a case of relapsed/refractory DLBCL that secondarily affected the heart. CASE PRESENTATION: A male patient was diagnosed with double-expressor DLBCL based on biopsies of mediastinal and peripancreatic masses and fluorescence in situ hybridization. The patient received first-line chemotherapy and anti-CD19 CAR T cell immunotherapy, but developed heart metastases after 12 months. Considering his physical condition and economic situation of the patient, two cycles of multiline chemotherapies were administered, followed by CAR-NK cell immunotherapy and allogeneic hematopoietic stem cell transplantation (allo-HSCT) at another hospital. After achieving a six-month survival, the patient died of severe pneumonia. CONCLUSION: The response of our patient emphasizes the importance of early diagnosis and timely treatment to improve the prognosis of SCL and serves as an important reference for SCL treatment strategies.
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spelling pubmed-99231202023-02-14 Relapsed/refractory diffuse large B cell lymphoma with cardiac involvement: A case report and literature review Yang, Yuanyuan Li, Zixuan Li, Yuntao Zhao, Yue Shi, Mingxia Front Oncol Oncology BACKGROUND: Hematological malignancies of the heart (CHMs) are extremely rare, and include leukemia, lymphoma infiltration, and multiple myeloma with extramedullary manifestations. Cardiac lymphoma can be divided into primary cardiac lymphoma (PCL) and secondary cardiac lymphoma (SCL). Compared to PCL, SCL is relatively more common. Histologically, the most frequent SCL is diffuse large B-cell lymphoma (DLBCL). The prognosis of lymphoma in patients with cardiac involvement is extremely poor. CAR T-cell immunotherapy has been recently become a highly effective treatment for relapsed or refractory diffuse large B-cell lymphoma. To date, there are no guidelines that provide a clear consensus on the management of patients with secondary heart or pericardial involvement. We report a case of relapsed/refractory DLBCL that secondarily affected the heart. CASE PRESENTATION: A male patient was diagnosed with double-expressor DLBCL based on biopsies of mediastinal and peripancreatic masses and fluorescence in situ hybridization. The patient received first-line chemotherapy and anti-CD19 CAR T cell immunotherapy, but developed heart metastases after 12 months. Considering his physical condition and economic situation of the patient, two cycles of multiline chemotherapies were administered, followed by CAR-NK cell immunotherapy and allogeneic hematopoietic stem cell transplantation (allo-HSCT) at another hospital. After achieving a six-month survival, the patient died of severe pneumonia. CONCLUSION: The response of our patient emphasizes the importance of early diagnosis and timely treatment to improve the prognosis of SCL and serves as an important reference for SCL treatment strategies. Frontiers Media S.A. 2023-01-30 /pmc/articles/PMC9923120/ /pubmed/36793603 http://dx.doi.org/10.3389/fonc.2023.1091074 Text en Copyright © 2023 Yang, Li, Li, Zhao and Shi https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Oncology
Yang, Yuanyuan
Li, Zixuan
Li, Yuntao
Zhao, Yue
Shi, Mingxia
Relapsed/refractory diffuse large B cell lymphoma with cardiac involvement: A case report and literature review
title Relapsed/refractory diffuse large B cell lymphoma with cardiac involvement: A case report and literature review
title_full Relapsed/refractory diffuse large B cell lymphoma with cardiac involvement: A case report and literature review
title_fullStr Relapsed/refractory diffuse large B cell lymphoma with cardiac involvement: A case report and literature review
title_full_unstemmed Relapsed/refractory diffuse large B cell lymphoma with cardiac involvement: A case report and literature review
title_short Relapsed/refractory diffuse large B cell lymphoma with cardiac involvement: A case report and literature review
title_sort relapsed/refractory diffuse large b cell lymphoma with cardiac involvement: a case report and literature review
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9923120/
https://www.ncbi.nlm.nih.gov/pubmed/36793603
http://dx.doi.org/10.3389/fonc.2023.1091074
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