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Findings that shed new light on the possible pathogenesis of a disease or an adverse effect
Case report
Transformation to plasmablastic lymphoma in CLL upon ibrutinib treatment
  1. Kristo Marvyin1,
  2. Eirik Brekka Tjønnfjord1,
  3. Unni Mathilde Breland1 and
  4. Geir Erland Tjønnfjord2
  1. 1Department of Haematology, Sykehuset Østfold HF, Gralum, Østfold, Norway
  2. 2Department of Haematology, Oslo Universitetssykehus, Oslo, Norway
  1. Correspondence to Kristo Marvyin; marvyin{at}gmail.com

Abstract

Chronic lymphatic leukaemia (CLL) is the most common leukaemia in the Western world. Ibrutinib, a tyrosine kinase inhibitor, is the treatment of choice on relapse or p53-dysfunction. Richter’s transformation to diffuse large B cell lymphoma is most often seen. However, transformation to other aggressive lymphomas as plasmablastic lymphoma (PBL) does occur. PBL is an extremely aggressive lymphoma and is usually treated using a CHOP-like regimen (cyclophosphamide, doxorubicin, vincristine and prednisone/dexamethasone), but with poor outcome. The only curative treatment is allogeneic stem cell transplant (ASCT).

We report on a case of CLL treated with ibrutinib that underwent transformation to PBL. Due to high expression of CD138, we added daratumumab to the chemotherapy with a good, but transitory response. The case did not make it to an ASCT. Targeting CD138 by daratumumab may be added to chemoimmune therapy for PBL.

  • haematology (incl blood transfusion)
  • chemotherapy

https://doi.org/10.1136/bcr-2020-235816

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    Footnotes

    • Contributors KM, UMB, EBT and GET contributed with valuable inputs regarding original ideas, design and supervision of this article.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Next of kin consent obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.