Spontaneous Regression Of Mantle Cell Lymphoma: A Report Of Four Cases
Ye, H., Desai, A., Gong, T., Zeng, D., Nomie, K., Chen, W., Wang, W., Romaguera, J., & Wang, M. L. (2018). spontaneous regression of mantle cell lymphoma: a report of four cases. Cancer communications (London, England), 38(1), 30. https://doi.org/10.1186/s40880-018-0306-z
View Original Source →Abstract
Spontaneous regression has been reported in some indolent forms of lymphoma. Mantle cell lymphoma (MCL) is an aggressive lymphoid neoplasm and has a poor prognosis. However, approximately 30% of MCL patients can exhibit indolent clinical behavior. To date, complete spontaneous regression of MCL has not been reported. We describe four cases of spontaneous regression of MCL. At the time of presentation, these patients were asymptomatic, with lymph node enlargement and mild to moderate fluorodeoxyglucose (FDG) uptake on FDG-positron emission tomography combined with computed tomography. One of the possible mechanisms of spontaneous regression of the tumor could be due to the host immune response through humoral and cellular immunity, which may have a role in the clearance of tumor cells. In this report, we support the use of a “wait and watch” strategy for MCL patients with no risk factors and indolent behavior. This strategy helps spare patients from further potentially harmful chemotherapy. In addition, we describe the phenomenon of spontaneous regression in MCL patients who are asymptomatic and have low-volume disease.
Case Details
Disease Location
Bilateral inguinal and pelvic lymph nodes
Personal Characteristics
44 -year-old female
Clinical Characteristics
Mantle cell lymphoma (mcl) patient complained of left groin pain for 3-4 weeks. In august 2015, she underwent CT scans of the abdomen and pelvis which revealed bilateral inguinal and pelvis lymphadenopathy ultrasound of the inguinal ln demonstrated multiple enlarged hypoechoic lymph nodes, the largest measuring 2.7x1.3cm on the left side, and 3.3x2.4cm on the right side. A left inguinal ln ultrasound-guided needle core biopsy showed mcl with nodular and diffuse patterns and ki-67 value of 10% fish assays were positive for the translocation between the ccnd1 gene located on 11q13 and the igh gene located on 14q32 (90% of cells) later, PET-CT showed mild to moderate fdg uptake in multiple nodal areas including the inguinal, left external iliac chain, and bilateral axillary lymph nodes with a max suv of 1.3-2.9. There was involvement of the bone marrow with 5% of total marrow cellularity in october 2015, physical exam revealed palpable bilateral inguinal lymph nodes measuring 1-3cm. Observational treatment was undergone
Remission Characteristics
A PET-CT in january 2016 showed a decrease in tumor size and uptake of fdg-avid disease, suggesting partial sr in may 2016 and jan 2017, repeat PET-CT showed stable disease
Treatment & Mechanisms
Proposed Remission Mechanisms
The host immune response through humoral and cellular immunity may play a central role in the clearance of tumor cells and contribute to sr
Clinical Treatment
None reported
Non-Clinical Treatment
None reported