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Spontaneous Regression Of Mantle Cell Lymphoma: A Report Of Four Cases

Ye, H. 2018Lymphoma

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

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Abstract

BACKGROUND: 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. CASE PRESENTATION: 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. CONCLUSIONS: 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

Lymph nodes

Personal Characteristics

48-year-old man, diagnosed with mantle cell lymphoma (mcl) treated with rituximab, cladribine, and vorinostat, receiving six cycles

Clinical Characteristics

A left inguinal lymph node grew a year later. Recurrence of mcl was confirmed by core needle biopsy. The pathology report at the time described a diffuse lymphoid infiltrate of non-blastoid cytology composed of small- to medium-sized lymphoid cells that were cyclin d1-positive.

Remission Characteristics

Residual adenopathy spontaneously regressed after the first follow-up examination

Treatment & Mechanisms

Proposed Remission Mechanisms

Host immune response through humoral and cellular immunity may play a central role

Clinical Treatment

Biopsy rituximab, cladribine, and vorinostat, receiving six cycles (before regression)

Non-Clinical Treatment

None reported