Bortezomib, Ifosfamide, Carboplatin, and Etoposide in a Patient with HIV-Negative Relapsed Plasmablastic Lymphoma

Plasmablastic lymphoma (PBL) is a rare subtype of diffuse large B cell lymphoma (DLBCL), often associated with HIV infection. We present a case of a 53-year-old HIV-negative man with untreated hepatitis C viral infection who presented with abdominal pain and lymphadenopathy. Lymph node and bone marr...

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Main Authors: Mehmet Akce, Elaine Chang, Mohammad Haeri, Mike Perez, Christie J. Finch, Mark M. Udden, Martha P. Mims
Format: Article
Language:English
Published: Wiley 2016-01-01
Series:Case Reports in Hematology
Online Access:http://dx.doi.org/10.1155/2016/3598547
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author Mehmet Akce
Elaine Chang
Mohammad Haeri
Mike Perez
Christie J. Finch
Mark M. Udden
Martha P. Mims
author_facet Mehmet Akce
Elaine Chang
Mohammad Haeri
Mike Perez
Christie J. Finch
Mark M. Udden
Martha P. Mims
author_sort Mehmet Akce
collection DOAJ
description Plasmablastic lymphoma (PBL) is a rare subtype of diffuse large B cell lymphoma (DLBCL), often associated with HIV infection. We present a case of a 53-year-old HIV-negative man with untreated hepatitis C viral infection who presented with abdominal pain and lymphadenopathy. Lymph node and bone marrow biopsies were consistent with plasmablastic lymphoma. He had partial response (PR) to 6 cycles of EPOCH but disease progressed seven weeks later. Repeat biopsy was consistent with plasmablastic lymphoma. Three cycles of bortezomib, ifosfamide, carboplatin, and etoposide (B-ICE) chemotherapy resulted in a partial response (PR). Five months later, he presented with widespread lymphadenopathy and tumor lysis syndrome with circulating blasts. Flow cytometry revealed a different population of lymphoma cells, this time positive for CD5, CD19, CD20, and CD22, with dim expression of CD45 and CD38. The patient died on the first day of ESHAP chemotherapy. There are no treatment recommendations or standard of care for plasmablastic lymphoma. A literature search yielded 10 cases in which bortezomib was administered in either HIV-positive or HIV-negative PBL. Six reported a partial response, 3 reported a complete response, and 1 was a near-complete response. Bortezomib, in combination with chemotherapy, may be an effective treatment option in PBL as reported here.
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spelling doaj-art-73a095b982314de98c53c356e01fd1f82025-02-03T01:20:25ZengWileyCase Reports in Hematology2090-65602090-65792016-01-01201610.1155/2016/35985473598547Bortezomib, Ifosfamide, Carboplatin, and Etoposide in a Patient with HIV-Negative Relapsed Plasmablastic LymphomaMehmet Akce0Elaine Chang1Mohammad Haeri2Mike Perez3Christie J. Finch4Mark M. Udden5Martha P. Mims6Department of Medicine, Section of Hematology-Oncology, Baylor College of Medicine, Houston, TX 77030, USADepartment of Medicine, Section of Hematology-Oncology, Baylor College of Medicine, Houston, TX 77030, USADepartment of Pathology, Baylor College of Medicine, Houston, TX 77030, USADepartment of Pathology, Baylor College of Medicine, Houston, TX 77030, USADepartment of Pathology, Baylor College of Medicine, Houston, TX 77030, USADepartment of Medicine, Section of Hematology-Oncology, Baylor College of Medicine, Houston, TX 77030, USADepartment of Medicine, Section of Hematology-Oncology, Baylor College of Medicine, Houston, TX 77030, USAPlasmablastic lymphoma (PBL) is a rare subtype of diffuse large B cell lymphoma (DLBCL), often associated with HIV infection. We present a case of a 53-year-old HIV-negative man with untreated hepatitis C viral infection who presented with abdominal pain and lymphadenopathy. Lymph node and bone marrow biopsies were consistent with plasmablastic lymphoma. He had partial response (PR) to 6 cycles of EPOCH but disease progressed seven weeks later. Repeat biopsy was consistent with plasmablastic lymphoma. Three cycles of bortezomib, ifosfamide, carboplatin, and etoposide (B-ICE) chemotherapy resulted in a partial response (PR). Five months later, he presented with widespread lymphadenopathy and tumor lysis syndrome with circulating blasts. Flow cytometry revealed a different population of lymphoma cells, this time positive for CD5, CD19, CD20, and CD22, with dim expression of CD45 and CD38. The patient died on the first day of ESHAP chemotherapy. There are no treatment recommendations or standard of care for plasmablastic lymphoma. A literature search yielded 10 cases in which bortezomib was administered in either HIV-positive or HIV-negative PBL. Six reported a partial response, 3 reported a complete response, and 1 was a near-complete response. Bortezomib, in combination with chemotherapy, may be an effective treatment option in PBL as reported here.http://dx.doi.org/10.1155/2016/3598547
spellingShingle Mehmet Akce
Elaine Chang
Mohammad Haeri
Mike Perez
Christie J. Finch
Mark M. Udden
Martha P. Mims
Bortezomib, Ifosfamide, Carboplatin, and Etoposide in a Patient with HIV-Negative Relapsed Plasmablastic Lymphoma
Case Reports in Hematology
title Bortezomib, Ifosfamide, Carboplatin, and Etoposide in a Patient with HIV-Negative Relapsed Plasmablastic Lymphoma
title_full Bortezomib, Ifosfamide, Carboplatin, and Etoposide in a Patient with HIV-Negative Relapsed Plasmablastic Lymphoma
title_fullStr Bortezomib, Ifosfamide, Carboplatin, and Etoposide in a Patient with HIV-Negative Relapsed Plasmablastic Lymphoma
title_full_unstemmed Bortezomib, Ifosfamide, Carboplatin, and Etoposide in a Patient with HIV-Negative Relapsed Plasmablastic Lymphoma
title_short Bortezomib, Ifosfamide, Carboplatin, and Etoposide in a Patient with HIV-Negative Relapsed Plasmablastic Lymphoma
title_sort bortezomib ifosfamide carboplatin and etoposide in a patient with hiv negative relapsed plasmablastic lymphoma
url http://dx.doi.org/10.1155/2016/3598547
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