[T-cell lymphoma arising during epcoritamab therapy for relapsed diffuse large B-cell lymphoma]

Area of Science:

• Hematology
• Oncology
• Immunotherapy

Background:

• Diffuse large B-cell lymphoma (DLBCL) is an aggressive non-Hodgkin lymphoma.
• Relapsed DLBCL often requires salvage chemotherapy and consideration of novel agents.
• Bispecific antibodies represent a new frontier in lymphoma treatment.

Purpose of the Study:

• To report a rare case of secondary peripheral T-cell lymphoma (PTCL) emergence during bispecific antibody therapy for relapsed DLBCL.
• To highlight potential risks associated with novel immunotherapies.

Main Methods:

• Case report of a 78-year-old female patient with relapsed DLBCL.
• Review of treatment history including R-THP-COP, R-ESHAP, and epcoritamab.
• Diagnostic workup for suspected relapse including sIL2R, PET-CT, bone marrow biopsy, and CSF analysis.

Main Results:

• Patient initially responded to epcoritamab but developed fever and altered mental status.
• Investigations confirmed transformation to peripheral T-cell lymphoma, not otherwise specified (PTCL-NOS).
• The patient experienced a rapid, aggressive clinical course and succumbed to the disease.

Conclusions:

• Bispecific antibody therapy, similar to CAR-T cell therapy, may be associated with the emergence of aggressive T-cell lymphomas.
• Close monitoring for secondary malignancies is crucial during novel immunotherapies.
• This case underscores the complex landscape of lymphoma treatment and potential treatment-related complications.