Debulking surgery for patients with diffuse large B-cell non-Hodgkin's lymphoma

Leukemia & Lymphoma
Margarita TokarOfer Shpilberg

Abstract

Chemotherapy and radiotherapy have been the principal modalities of treatment for diffuse large B-cell non-Hodgkin's lymphoma (B-NHL) for over 30 years. Various treatment regimens have been designed over the years to try to increase response and cure rates. The role of surgery has been generally restricted to defined and limited situations including diagnostic tissue biopsies and treating abdominal emergencies such as organ rupture or perforation. We present two cases of refractory B-NHL, where surgery was used as a part of stepwise and multi-modal treatment with curative intent. In both cases, the treatment approach included standard dose chemotherapy, eradication of residual mass by surgery, high dose chemotherapy (HDC) with stem cell support and posttransplantant immunotherapy. Currently, 2 years after completing the therapy, both patients are well with no evidence of active disease. Based on our experience with 2 patients we believe that in specific cases of residual chemo-resistant lymphomatous mass, surgery should be considered as a part of a multimodal approach.

References

Jul 1, 1995·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·M A RodriguezJ E Romaguera
Aug 24, 1999·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·M A ShippB Coiffier
Jul 25, 2000·Annals of Oncology : Official Journal of the European Society for Medical Oncology·D G SavageS A Johnson
Jun 4, 2002·Cancer Chemotherapy and Pharmacology·Fredrick B Hagemeister

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