Part 3: Aggressive B-Cell Non-Hodgkin Lymphoma

Leena Varkey Maramattom, MD

Mazie Froedtert Willms & Sue Froedtert Cancer Fellow, Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, WI

Timothy S. Fenske, MD

Associate Professor of Medicine, Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, WI

Question 5

Questions 4 and 5 are based on the following clinical scenario:
A 57-year-old man presents with neck swelling, night sweats, and fatigue. On further evaluation he is found to have diffuse lymphadenopathy, splenomegaly, and lymphocytosis. He undergoes an excisional lymph node biopsy which shows mantle cell lymphoma (MCL). Staging evaluation reveals extensive adenopathy above and below the diaphragm (with some sites in the 5 to 10 cm range), splenomegaly, bone marrow involvement, and a moderately elevated LDH.

Treatment options for this patient with newly diagnosed MCL would include which of the following options?

  •  Observation (“watch and wait”)
  •  R-CHOP (rituximab, cyclophosphamide, vincristine, prednisone), with or without
    autologous stem cell transplantation in first remission
  •  R-hyperCVAD (rituximab, hyperfractionated cyclophosphamide, vincristine,
    doxorubicin, and dexamethasone)
  •  R-hyperCVAD followed by autologous stem cell transplantation
  •  Options B, C, or D

Updated 7/05/2011 • jdw | Copyright ©2014 Turner White Communications