Second-Line Therapy in Extranodal Marginal Zone Lymphoma
Second-Line Therapy in Extranodal Marginal Zone Lymphoma
A 64-Year-Old Woman With Advanced Extranodal MZL
January 2016
- PH: At age 64, the patient presented with a fever of unknown origin, weight loss, and fatigue
- PE: revealed 2 masses near left ear
- PMH: Sjogren’s syndrome, symptoms managed on cevimeline
- CT revealed bilateral involvement in parotid glands and a 3.0-cm. mass in the left lung
- Biopsies confirmed presence of MALT lymphoma in salivary gland and lung with nodules of diffuse heterogeneous B-cell infiltrate
- IHC: B cell phenotype CD20
- HBC, HBV, and other infections ruled out
Treatment History
- After 6-month period of active monitoring/observation, salivary masses began to cause patient distress; she also developed a persistent cough
- CT revealed an additional new mass in left lung
- Decision was made to start patient on a course of rituximab
- Follow-up imaging at 6 months and 9 months showed near complete remission
March 2018
- Imaging at 20 months showed disease progression in the lung
- Patient started on treatment with rituximab monotherapy
June 2018
- Imaging at 3 months showed no response to therapy
- The patient was started on treatment with ibrutinib
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