Triplet Therapy with PD-1 Blockade, Histone Deacetylase Inhibitor, and DNA Methyltransferase Inhibitor Achieves Radiological Response in Refractory Double-Expressor Diffuse Large B-cell Lymphoma with 17p Deletion
Double-expressor diffuse large B-cell lymphoma (DLBCL) with 17p deletion is an aggressive and refractory disease. Immune checkpoint blockade and epigenetic drugs have been widely used, but the efficacy of different combined applications varied. We report a case with “double-expressor” DLBCL treated...
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| Format: | Article |
| Language: | English |
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Wiley
2020-01-01
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| Series: | Case Reports in Hematology |
| Online Access: | http://dx.doi.org/10.1155/2020/8879448 |
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| _version_ | 1832567419730657280 |
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| author | Runhui Zheng Xiaobo Chen Chunyan Wang Pengfei Qin Huo Tan Xiaodan Luo |
| author_facet | Runhui Zheng Xiaobo Chen Chunyan Wang Pengfei Qin Huo Tan Xiaodan Luo |
| author_sort | Runhui Zheng |
| collection | DOAJ |
| description | Double-expressor diffuse large B-cell lymphoma (DLBCL) with 17p deletion is an aggressive and refractory disease. Immune checkpoint blockade and epigenetic drugs have been widely used, but the efficacy of different combined applications varied. We report a case with “double-expressor” DLBCL treated with a combined regimen which consisted of programmed cell death protein 1 (PD-1) inhibitor, DNA methyltransferase inhibitor (DNMTi), and histone deacetylase inhibitor (HDACi). A 50-year-old man presented with a 6-month history of hoarseness, and 10 days of progressive shortness of breath was diagnosed of DLBCL, stage IV. The patient failed to respond to the 1st line (R-EPOCH: rituximab, etoposide, vincristine, cyclophosphamide, doxorubicin, and dexamethasone), 2nd line (R-EPOCH + lenalidomide + ibrutinib), and a 3rd line chemotherapy combined with PD-1 inhibitor (sintilimab), decitabine, and GDP (gemcitabine, DDP, and dexamethasone). Surprisingly, patient’s condition was improved after treatment with PD-1 inhibitor in combination with DNMTi/HDACi. Restaging PET revealed dramatically radiological response. |
| format | Article |
| id | doaj-art-0190a0af14a5460488c58aae0aecdfbb |
| institution | Kabale University |
| issn | 2090-6560 2090-6579 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Hematology |
| spelling | doaj-art-0190a0af14a5460488c58aae0aecdfbb2025-02-03T01:01:27ZengWileyCase Reports in Hematology2090-65602090-65792020-01-01202010.1155/2020/88794488879448Triplet Therapy with PD-1 Blockade, Histone Deacetylase Inhibitor, and DNA Methyltransferase Inhibitor Achieves Radiological Response in Refractory Double-Expressor Diffuse Large B-cell Lymphoma with 17p DeletionRunhui Zheng0Xiaobo Chen1Chunyan Wang2Pengfei Qin3Huo Tan4Xiaodan Luo5Department of Hematology, First Affiliated Hospital, Guangzhou Medical University, Guangzhou 510230, ChinaGuangzhou Institute of Respiratory Health, Guangzhou Medical University, Guangzhou 510120, ChinaDepartment of Hematology, First Affiliated Hospital, Guangzhou Medical University, Guangzhou 510230, ChinaDepartment of Hematology, First Affiliated Hospital, Guangzhou Medical University, Guangzhou 510230, ChinaDepartment of Hematology, First Affiliated Hospital, Guangzhou Medical University, Guangzhou 510230, ChinaDepartment of Hematology, First Affiliated Hospital, Guangzhou Medical University, Guangzhou 510230, ChinaDouble-expressor diffuse large B-cell lymphoma (DLBCL) with 17p deletion is an aggressive and refractory disease. Immune checkpoint blockade and epigenetic drugs have been widely used, but the efficacy of different combined applications varied. We report a case with “double-expressor” DLBCL treated with a combined regimen which consisted of programmed cell death protein 1 (PD-1) inhibitor, DNA methyltransferase inhibitor (DNMTi), and histone deacetylase inhibitor (HDACi). A 50-year-old man presented with a 6-month history of hoarseness, and 10 days of progressive shortness of breath was diagnosed of DLBCL, stage IV. The patient failed to respond to the 1st line (R-EPOCH: rituximab, etoposide, vincristine, cyclophosphamide, doxorubicin, and dexamethasone), 2nd line (R-EPOCH + lenalidomide + ibrutinib), and a 3rd line chemotherapy combined with PD-1 inhibitor (sintilimab), decitabine, and GDP (gemcitabine, DDP, and dexamethasone). Surprisingly, patient’s condition was improved after treatment with PD-1 inhibitor in combination with DNMTi/HDACi. Restaging PET revealed dramatically radiological response.http://dx.doi.org/10.1155/2020/8879448 |
| spellingShingle | Runhui Zheng Xiaobo Chen Chunyan Wang Pengfei Qin Huo Tan Xiaodan Luo Triplet Therapy with PD-1 Blockade, Histone Deacetylase Inhibitor, and DNA Methyltransferase Inhibitor Achieves Radiological Response in Refractory Double-Expressor Diffuse Large B-cell Lymphoma with 17p Deletion Case Reports in Hematology |
| title | Triplet Therapy with PD-1 Blockade, Histone Deacetylase Inhibitor, and DNA Methyltransferase Inhibitor Achieves Radiological Response in Refractory Double-Expressor Diffuse Large B-cell Lymphoma with 17p Deletion |
| title_full | Triplet Therapy with PD-1 Blockade, Histone Deacetylase Inhibitor, and DNA Methyltransferase Inhibitor Achieves Radiological Response in Refractory Double-Expressor Diffuse Large B-cell Lymphoma with 17p Deletion |
| title_fullStr | Triplet Therapy with PD-1 Blockade, Histone Deacetylase Inhibitor, and DNA Methyltransferase Inhibitor Achieves Radiological Response in Refractory Double-Expressor Diffuse Large B-cell Lymphoma with 17p Deletion |
| title_full_unstemmed | Triplet Therapy with PD-1 Blockade, Histone Deacetylase Inhibitor, and DNA Methyltransferase Inhibitor Achieves Radiological Response in Refractory Double-Expressor Diffuse Large B-cell Lymphoma with 17p Deletion |
| title_short | Triplet Therapy with PD-1 Blockade, Histone Deacetylase Inhibitor, and DNA Methyltransferase Inhibitor Achieves Radiological Response in Refractory Double-Expressor Diffuse Large B-cell Lymphoma with 17p Deletion |
| title_sort | triplet therapy with pd 1 blockade histone deacetylase inhibitor and dna methyltransferase inhibitor achieves radiological response in refractory double expressor diffuse large b cell lymphoma with 17p deletion |
| url | http://dx.doi.org/10.1155/2020/8879448 |
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