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CC BY 4.0 · Indian J Med Paediatr Oncol 2022; 43(06): 523-527
DOI: 10.1055/s-0042-1749412
Case Report with Review of Literature

Refractory Primary Mediastinal B-Cell Lymphoma: A Case Report of Conventional Chemotherapies, Immune Checkpoint Inhibitors, Polatuzumab Vedotin, Transplantation, and Post-Transplant Large Granular Lymphocytosis

Rajat Pincha
1   Clinical Hematology Oncology and HCT, Tata Medical Center, Kolkata, West Bengal, India
,
Vivek S. Radhakrishnan 
1   Clinical Hematology Oncology and HCT, Tata Medical Center, Kolkata, West Bengal, India
,
Jeevan Kumar
1   Clinical Hematology Oncology and HCT, Tata Medical Center, Kolkata, West Bengal, India
,
Arijit Nag 
1   Clinical Hematology Oncology and HCT, Tata Medical Center, Kolkata, West Bengal, India
,
Saurabh Jayant Bhave
1   Clinical Hematology Oncology and HCT, Tata Medical Center, Kolkata, West Bengal, India
,
Lateef Zameer
2   Department of Histopathology, Tata Medical Center, Kolkata, West Bengal, India
,
Sushant S. Vinarkar
3   Laboratory Hematology and Molecular Pathology, Tata Medical Center, Kolkata, West Bengal, India
,
Jayanta Das 
4   Department of Nuclear Medicine, Tata Medical Center, Kolkata, West Bengal, India
,
Deepak Kumar Mishra
3   Laboratory Hematology and Molecular Pathology, Tata Medical Center, Kolkata, West Bengal, India
,
Mammen Chandy
1   Clinical Hematology Oncology and HCT, Tata Medical Center, Kolkata, West Bengal, India
,
Reena Nair
1   Clinical Hematology Oncology and HCT, Tata Medical Center, Kolkata, West Bengal, India
› Author Affiliations Funding None.
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Abstract

We report a case of stage IV primary mediastinal B-cell lymphoma in a 27-year-old young woman, who was refractory and chemoresistant to frontline conventional rituximab-based intensive chemotherapy and subsequent lines of conventional and immune checkpoint inhibitor-based therapies. She was successfully treated using a polatuzumab-based regimen and consolidated with an allogeneic haploidentical hematopoietic stem cell transplantation. She developed post-transplant large granular lymphocytosis that was managed conservatively. She is now relapse-free, 600 days post-transplant. The management of this patient provided several teaching points in the use of different modalities of immunotherapies in a hard-to-treat cancer and its related conditions.

Keywords

primary mediastinal B-cell Lymphoma - relapsed refractory disease - chemoresistance - polatuzumab vedotin - haploidentical transplantation

Authors' Contribution

VSR conceived and led the idea for the case report. VSR, RP, and RN wrote the manuscript, contributed to the design, and edited the manuscript. LZ, SSV, DKM, and JD contributed to pathology, laboratory hematology, and imaging inputs, respectively, pictures and edited the manuscript. VSR, RN, RP, JK, SB, AN, and MC examined and treated the patient, and edited the manuscript.


Availability of Data and Material (data transparency)

Data sharing not applicable to this article as no datasets were generated or analyzed during the current study.


Declaration of Patient Consent

Informed consent was taken from the patient.


Supplementary Material



Publication History

Article published online:
28 July 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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