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  • Successful treatment of concomitant metastatic prostate cancer and B-cell non-Hodgkin’s lymphoma with R-EPOCH chemotherapy regimen and antiandrogen therapy

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Unusual association of diseases/symptoms
CASE REPORT
Successful treatment of concomitant metastatic prostate cancer and B-cell non-Hodgkin’s lymphoma with R-EPOCH chemotherapy regimen and antiandrogen therapy
  1. Fayez Hanna1,
  2. Ajay Prakash2,3,
  3. Ebony Allan3,
  4. Alhossain A Khalafallah1,3,4,5
  1. 1Faculty of Health Sciences, University of Tasmania, Launceston, Tasmania, Australia
  2. 2Haematology, Tasmanian Medical Laboratory, Launceston, Tasmania, Australia
  3. 3Haematology Department, Specialist Care Australia, Launceston, Tasmania, Australia
  4. 4Launceston General Hospital, Launceston, Tasmania, Australia
  5. 5Menzies Institute for Medical Research, University of Tasmania, Launceston, Tasmania, Australia
  1. Correspondence to Professor Alhossain A Khalafallah, Alhossain{at}yahoo.com

Summary

A 70-year-old man presented with left loin pain without urinary symptoms. Initial investigations with CT showed enlarged para-aortic, mediastinal lymph nodes, right-side renal mass and enlarged prostate. A prostatic-specific antigen (PSA) was alarmingly high at 4750 μg/L (normal <4.0 μg/L). Further investigations included positron emission tomography (PET); both prostate-specific membrane antigen and 18-fluorodeoxyglucose as well as bone scan and bone marrow examination confirmed dual malignancies with B-cell non-Hodgkin’s lymphoma (B-NHL) and wide spread metastatic prostatic adenocarcinoma (PA) to the skull, spine, pelvis, liver and lungs. The patient was treated with six cycles of rituximab, etoposide, prednisone, vincristine, cyclophosphamide and doxorubicin(R-EPOCH) containing regimen for B-NHL and goserelin hormonal therapy for PA. Restaging with PET scans thereafter showed complete remission of NHL with disappearance of his metastatic PA and normalisation of PSA levels. R-EPOCH regimen and antiandrogen therapy resulted in a good outcome and remission of both malignancies.

  • malignant and benign haematology
  • malignant disease and immunosuppression
  • prostate cancer

https://doi.org/10.1136/bcr-2017-223637

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    Footnotes

    • Contributors FH interviewed the patient and drafted the manuscript. AP entered the results and updated the discussion. EA treated the patient and organised the graphs and edited the manuscript. AAK supervised all aspects of manuscript and edited and wrote the manuscript.

    • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent Obtained.

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