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
Right axillary ln
Personal Characteristics
63 -year-old male
Clinical Characteristics
Mantle cell lymphoma (mcl) was diagnosed in oct 2009 initial pathology was reported as a diffuse pattern with a ki-67 value of 10-15% and 5% marrow involvement initially treated with rituximab, and hyper-cvad alternated with rituximab, methotrexate, and cytarabine; 3 cycles of each for 6 total cycles. Treatment was completed in dec 2010 in april 2014, disease relapsed in the right axilary ln, evidenced via ln biopsy. At that time, CT were negative
Remission Characteristics
After treatment, complete remission was achieved for 4 years until april 2014 3 months later, without therapy, chest CT showed a decrease in the size of the ln PET-CT between oct 2016 and april 2017 showed no suspicious activity and sr of the existing 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
Rituximab and hyper-cvad (fractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone) alternated with rituximab, methotrexate, and cytarabine
Non-Clinical Treatment
None reported