Successful CNS-Centric Therapeutic Management and Genomic Profiling of Primary Cranial Vault Diffuse Large B-Cell Lymphoma.
Jordan DavisErinMarie O KimbroughMuhamad Alhaj MoustafaLiuyan JiangVivek GuptaEphraim ParentHan W TunPublished in: Journal of blood medicine (2023)
Primary cranial vault lymphoma (PCVL) is a rare lymphoma involving the skull with or without extra- and intracranial extension. Most cases of PCVL are diffuse large B-cell lymphoma (DLBCL). We report a case of primary cranial vault diffuse large B-cell lymphoma (PCV-DLBCL) that was successfully treated with anthracycline-based chemoimmunotherapy (CIT) alternating with central nervous system (CNS)-directed CIT with high-dose methotrexate and high-dose cytarabine. CNS-centric therapy was given for suspected cerebral cortical involvement and presumed elevated risk of CNS recurrence. The patient has remained in complete remission for 4.25 years following treatment. We suggest that PCV-DLBCL is potentially curable with CNS-directed therapy. Additionally, we provide genomic profiling results indicating an indeterminate cell of origin and multiple genetic mutations which are not frequently seen in DLBCL.
Keyphrases
- diffuse large b cell lymphoma
- high dose
- epstein barr virus
- blood brain barrier
- stem cell transplantation
- low dose
- single cell
- copy number
- case report
- cell therapy
- subarachnoid hemorrhage
- stem cells
- gene expression
- brain injury
- systemic lupus erythematosus
- mesenchymal stem cells
- bone marrow
- disease activity
- cerebral ischemia
- cerebrospinal fluid
- dna methylation
- combination therapy
- optic nerve
- smoking cessation
- optical coherence tomography
- fine needle aspiration