Integrative approach to diagnosis and subsequent successful therapy of refractory follicular lymphoma using obinutuzumab in combination with bendamustine. Clinical observation

Cover Page

Cite item

Full Text

Abstract

In the presented observation, a female patient with diagnosis of nodular lymphocyte-predominant Hodgkin lymphoma (advanced stages) received R-ABVD regimen therapy. Return of clinical symptoms observed at the onset of the disease, as well as renewed growth of the lymph nodes after 4th therapy cycle showed refractory disease. Considering the results of earlier studies, generally showing high effectiveness of primary treatment of patients with nodular lymphocyte-predominant Hodgkin lymphoma, reevaluation of immunomorphological type of lymphoproliferative disease was performed. After change of diagnosis to grade 3A follicular lymphoma, therapy was changed to obinutuzumab in combination with bendamustine leading to fast positive antitumor effect.

About the authors

P. A. Zeynalova

Clinical Hospital “Lapino” of the “Mother and Child” Group of companies; I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)

ORCID iD: 0000-0003-1564-424X

111 1st Uspenskoe Shosse, Lapino, Moscow region 143081

Bld. 2, 8 Trubetskaya St., Moscow 119991

Russian Federation

Yu. E. Ryabukhina

Clinical Hospital “Lapino” of the “Mother and Child” Group of companies

Author for correspondence.
Email: gemonk.yur@mail.ru
ORCID iD: 0000-0001-8443-8816

Yulia Evgenyevna Ryabukhina

111 1st Uspenskoe Shosse, Lapino, Moscow region 143081

Russian Federation

F. M. Abbasbeyli

Clinical Hospital “Lapino” of the “Mother and Child” Group of companies

ORCID iD: 0000-0002-2359-0547

111 1st Uspenskoe Shosse, Lapino, Moscow region 143081

Russian Federation

O. L. Timofeeva

Clinical Hospital “Lapino” of the “Mother and Child” Group of companies

ORCID iD: 0000-0002-6229-7300

111 1st Uspenskoe Shosse, Lapino, Moscow region 143081

Russian Federation

G. F. Allakhverdieva

Clinical Hospital “Lapino” of the “Mother and Child” Group of companies

ORCID iD: 0000-0001-5910-5892

111 1st Uspenskoe Shosse, Lapino, Moscow region 143081

Russian Federation

D. S. Abramov

Dmitry Rogachev National Research Center of Pediatric Hematology, Oncology and Immunology, Ministry of Health of Russia

ORCID iD: 0000-0003-3664-2876

1, Zamora Mashela St., Moscow 117997

Russian Federation

T. T. Valiev

I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)

ORCID iD: 0000-0002-1469-2365

Bld. 2, 8 Trubetskaya St., Moscow 119991

Russian Federation

References

  1. Matasar M.J., Luminari S., Barr P.M. et al. Follicular lymphoma: recent and emerging therapies, treatment strategies, and remaining unmet needs. Oncologist 2019;24(11):e1236–e50. doi: 10.1634/theoncologist.2019-0138
  2. Ott G., Katzenberger T., Lohr A. et al. Cytomorphologic, immunohistochemical, and cytogenetic profiles of follicular lymphoma: 2 types of follicular lymphoma grade 3. Blood 2002;99(10):3806–12. doi: 10.1182/blood.v99.10.3806
  3. Hiddemann W., Kneba M., Dreyling M. et al. Frontline therapy with Rituximab added to the combination of cyclophosphamide, doxorubicin, vincristine and prednisone (CHOP) significantly improves the outcome of patients with advanced stage follicular lymphomas as compared to CHOP alone: results of a prospective randomized study of the German Low-Grade Lymphoma Study Group (GLSG). Blood 2005;106(12):3725–32. doi: 10.1182/blood-2005-01-0016
  4. Marcus R., Imrie K., Solal-Celigny P. et al. Phase III study of R-CVP compared with cyclophosphamide, vincristine, and prednisolone alone in patients with previously untreated advanced follicular lymphoma. J Clin Oncol 2008;26(28):4579–86. doi: 10.1200/JCO.2007.13.5376
  5. Herold M., Haas A., Srock S. et al. Rituximab added to first-line mitoxantrone, chlorambucil, and prednisolone chemotherapy followed by interferon maintenance prolongs survival in patients with advanced follicular lymphoma: an East German Study Group Hematology and Oncology Study. J Clin Oncol 2007;25(15):1986–92. doi: 10.1200/JCO.2006.06.4618
  6. Rummel M.J., Niederle N., Maschmeyer G. et al. Bendamustine plus rituximab versus CHOP plus rituximab as first-line treatment for patients with indolent and mantle-cell lymphomas: an open-label, multicentre, randomised, phase 3 non-inferiority trial. Lancet 2013;381(9873):1203–10. doi: 10.1016/S0140-6736(12)61763-2
  7. Cheson B.D., Friedberg J.W., Kahl B.S. et al. Bendamustine produces durable responses with an acceptable safety profile in patients with rituximab-refractory indolent non-Hodgkin lymphoma. Clin Lymphoma Myeloma Leuk 2010;10(6):452–7. doi: 10.3816/CLML.2010.n.079
  8. Golay J., Da Roit F., Bologna L. et al. Glycoengineered CD20 antibody obinutuzumab activates neutrophils and mediates phagocytosis through CD16B more efficiently than rituximab. Blood 2013;122(20):3482–91. doi: 10.1182/blood-2013-05-504043
  9. Gazyva: Obinutuzumab. South San Francisco, CA: Genetech, Inc, 2016.
  10. Herter S., Herting F., Mundigl O. et al. Preclinical activity of the type II CD20 antibody GA101 (obinutuzumab) compared with rituximab and ofatumumab in vitro and in xenograft models. Mol Cancer Ther 2013;12(10):2031–42. doi: 10.1158/1535-7163.MCT-12-1182
  11. Sehn L.H., Chua N., Mayer J. et al. Obinutuzumab plus bendamustine versus bendamustine monotherapy in patients with rituximab-refractory indolent non-Нodgkin lymphoma (GADOLIN): a randomised, controlled, open-label, multicentre, phase 3 trial. Lancet Oncol 2016;17(8):1081–93. doi: 10.1016/S1470-2045(16)30097-3
  12. Babicheva L.G., Tumyan G.S., Osmanov E.A. et al. Follicular lymphoma. Clinical recommendations. Sovremennaya onkologiya = Journal of Modern Oncology 2020; 22(2):34–51. (In Russ.). doi: 10.26442/18151434.2020.2.200131
  13. Demina E.A., Tumyan G.S., Chekan A.A. et al. Rare disease – nodular lymphocyte-predominant Hodgkin’s lymphoma: literature review and own data. Klinicheskaya onkogematologiya = Clinical Oncohematology 2014;7(4):522–32. (In Russ.).
  14. Gotti M., Sciarra R., Pulsoni A. et al. Role of Rituximab addition to firstline chemotherapy regimens in nodular lymphocyte-predominant Hodgkin lymphoma: a study by Fondazione Italiana Linfomi. Hema-Sphere 2023;7(4):e837. doi: 10.1097/HS9.0000000000000837
  15. Diehl V., Sextro M., Franklin J. et al. Clinical presentation, course and prognostic factors in lymphocyte-predominant Hodgkin’s disease and lymphocyte-rich classical Hodgkin’s disease: report from the European task force on lymphoma project on lymphocyte-predominant Hodgkin’s disease. J Clin Oncol 2019;17(3):776–83. doi: 10.1200/JCO.1999.17.3.776
  16. Isaacson P.G. Malignant lymphomas with a follicular growth pattern. Histopathology 1996;28(6):487–95. doi: 10.1046/j.1365-2559.1996.d01-473.x
  17. Brune V., Tiacci E., Pfeil I. et al. Origin and pathogenesis of nodular lymphocyte-predominant Hodgkin lymphoma as revealed by global gene expression analysis. J Exp Med 2008;205(10):2251–68. doi: 10.1084/jem.20080809
  18. Nogová L., Reineke T., Brillant C. et al. Lymphocyte-predominant and classical Hodgkin’s lymphoma: a comprehensive analysis from the German Hodgkin Study Group. J Clin Oncol 2008;26(3):434–9. doi: 10.1200/JCO.2007.11.8869
  19. Hodgkin's lymphoma. Clinical recommendations. 2020. Available by: https://nodgo.org/sites/default/files/КР%20ЛХ%202020.pdf
  20. Hodgkin Lymphoma. Nodular Lymphocyte-Predominant Hodgkin Lymphoma. NCCN Clinical Practice Guidelines in Oncology. Version 2.2023.
  21. Fanale M.A., Cheah C.Y., Rich A.M. et al. Encouraging activity for R-CHOP in advanced stage nodular lymphocyte-predominant Hodgkin lymphoma. Blood 2017;130(4):472–7. doi: 10.1182/blood-2017-02-766121
  22. Cencini E., Fabbri A., Bocchia M. Rituximab plus ABVD in newly diagnosed nodular lymphocyte-predominant Hodgkin lymphoma. Br J Haematol 2017;176(5):831–3. doi: 10.1111/bjh.14001
  23. Pugliese N., Picardi M., Della Pepa M. et al. Rituximab-containing riskadapted treatment strategy in nodular lymphocyte predominant Hodgkin lymphoma: 7-years follow-up. Cancers (Basel) 2021;13(8):1760. doi: 10.3390/cancers13081760
  24. Follicular Lymphoma. NCCN Clinical Practice Guidelines in Oncology. Version 2.2023.
  25. Cheson B.D., Chua N., Mayer J. et al. Overall survival benefit in patients with rituximab-refractory indolent non-Hodgkin lymphoma who received obinutuzumab plus bendamustine induction and obinutuzumab maintenance in the GADOLIn study. J Clin Oncol 2018;36(22):2259–66. doi: 10.1200/JCO.2017.76.3656

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

Copyright (c) 2023 ABV-Press

License URL: https://mdonco.abvpress.ru/jour/about/editorialPolicies
СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия ПИ № ФС 77-81466 от  03.08.2021.