[Thalidomide therapy in relapsed diffuse large B-cell lymphoma in elderly patients. Three cases]

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Nikolett Wohner1, Gergely Varga1, Péter Szloboda2

  • 1III. Belgyógyászati Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Kútvölgyi út 4., 1125.

Orvosi Hetilap
|October 14, 2017
PubMed

Insights

Thalidomide shows promise for elderly patients with relapsed diffuse large B-cell lymphoma (DLBCL), a common non-Hodgkin lymphoma (NHL). This low-toxicity treatment offers an alternative for patients ineligible for high-toxicity therapies, with two of three cases achieving complete remission.

Area of Science:

  • Hematology
  • Oncology
  • Pharmacology

Background:

  • Diffuse large B-cell lymphoma (DLBCL) is the most common adult non-Hodgkin lymphoma (NHL).
  • Elderly patients with relapsed DLBCL face treatment challenges due to high chemotherapy toxicity.
  • Immunomodulatory drugs (IMiDs), like thalidomide, exhibit anti-angiogenic and immunomodulatory properties.

Observation:

  • Three elderly patients with relapsed DLBCL received thalidomide (100 mg) and corticosteroids.
  • Two patients had central nervous system (CNS) involvement; one had primary mediastinal disease.
  • Two patients achieved complete remission and remained progression-free for 12 and 20 months.

Findings:

  • Thalidomide treatment resulted in excellent responses in two elderly DLBCL patients.
  • One patient with CNS involvement progressed and unfortunately deceased despite therapy.
  • IMiDs demonstrate significant activity in relapsed DLBCL, particularly in elderly populations.

Implications:

  • Thalidomide offers a promising, low-cost, and low-toxicity treatment option for elderly patients with relapsed DLBCL.
  • This approach may be suitable for patients who cannot tolerate standard high-toxicity treatments.
  • Further investigation into thalidomide's efficacy in aggressive relapsed NHL is warranted.

Keywords:
DLBCLNHLrelapserelapsusthalidomidthalidomide

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