Refractory Primary Mediastinal B-Cell Lymphoma: A Case Report of Conventional Chemotherapies, Immune Checkpoint Inhibitors, Polatuzumab Vedotin, Transplantation, and Post-Transplant Large Granular Lymphocytosis

Abstract

We report a case of stage IV primary mediastinal B-cell lymphoma in a 27-year-old young woman, who was refractory and chemoresistant to frontline conventional rituximab-based intensive chemotherapy and subsequent lines of conventional and immune checkpoint inhibitor-based therapies. She was successfully treated using a polatuzumab-based regimen and consolidated with an allogeneic haploidentical hematopoietic stem cell transplantation. She developed post-transplant large granular lymphocytosis that was managed conservatively. She is now relapse-free, 600 days post-transplant. The management of this patient provided several teaching points in the use of different modalities of immunotherapies in a hard-to-treat cancer and its related conditions.

Keywords

primary mediastinal B-cell Lymphoma - relapsed refractory disease - chemoresistance - polatuzumab vedotin - haploidentical transplantation

Authors' Contribution

VSR conceived and led the idea for the case report. VSR, RP, and RN wrote the manuscript, contributed to the design, and edited the manuscript. LZ, SSV, DKM, and JD contributed to pathology, laboratory hematology, and imaging inputs, respectively, pictures and edited the manuscript. VSR, RN, RP, JK, SB, AN, and MC examined and treated the patient, and edited the manuscript.

Availability of Data and Material (data transparency)

Data sharing not applicable to this article as no datasets were generated or analyzed during the current study.

Declaration of Patient Consent

Informed consent was taken from the patient.

Publikationsverlauf

Artikel online veröffentlicht:
28. Juli 2022

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