Cure of cerebral lymphoma with only one course of chemotherapy: was dr. House right after all?

Cure of cerebral lymphoma with only one course of chemotherapy: was dr. House right after all?

Author Info

Corresponding Author
Dries Deeren
Hematology department, AZ Delta, Roeselare, Belgium

A B S T R A C T

We report on an elderly patient with primary diffuse large B-cell lymphoma of the central nervous system. Despite dose reduction of methotrexate (MTX), he developed acute renal failure with creatinine increase to 3.3 mg/dl and stomatitis grade 3. CT scan 16 days after chemotherapy showed complete remission. Because of the very poor tolerance of therapy and the complete response we decided to follow-up carefully but not put him through further treatment after this single administration of MTX. Now, 7 years later, he is still in complete remission and enjoys a great life quality, living with his family. Like a patient in a House episode, he suffered from serious complications of chemo, but this one chemo course saved his life. Renal failure may have caused longer circulation of MTX and extended antineoplastic activity as well as toxicity. This challenges the classic view that therapy dose should be reduced in elderly patients. Outcome may be good despite age or toxicity. Core tip: We challenge the classic view that therapy dose should be reduced in elderly patients. Outcome may be good despite age or toxicity.

Article Info

Article Type
Case Report
Publication history
Received: Sun 19, May 2019
Accepted: Thu 13, Jun 2019
Published: Fri 05, Jul 2019
Copyright
© 2019 Dries Deeren. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Hosting by Science Repository. All rights reserved.
DOI: 10.31487/j.RGM.2019.02.01