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84 years old female was diagnosed with stage 4 follicular lymphoma.Patient had swelling over fore head and scalp which was causing compression over eye.Being low grade lymphoma,patient was offered low intensity chemotherapy + targeted therapy : BR ( Rituximab + Bendamustine). With growth factors support .Patient had complete resolution of all lesions without any side effects at the end of first 3 cycles only.Low grade lymphomas can be treated with low intensity chemotherapy or sometimes only with targeted therapy alone.
The patient tolerated the chemotherapy and targeted therapy well and the disease is completely in remission now.
36 years old female presented with severe abdominal pain with jaundice with weakness being wheelchair bound.Her PETCT showed multiple liver metastasis with liver full of disease.However biopsy and immunohistochemistry confirmed high grade Burkitts lymphoma , her MIBI index was 98 % ,which is very aggresive lymphoma which is rapidly fatal if not treated early.She was urgently started on cytoreductive chemotherapy along with TLS prophylaxis of inj rasburicase ,and later intensive chemotherapy along with targeted therapy ( R- Dose adjusted EPOCH).She had rapid symptomatic relief and all liver lesions resolved and patient had complete resolution after 6 cycles of Chemotherapy.High grade lymphomas like Burkitts lymphoma are very aggressive but at the same time can be extremely responsive to high intensity treatment.
44 year female, non smoker , presented with cough and body ache, CT scan chest revealed bilateral lung masses with satellite nodules in both lung lobes , she also had pain full bony metastasis . Ct guided Biopsy revealed moderately differentiated adenocarcinoma , on NGS 9next generation sequencing ) she was EGFR Mutation positive . we started tab Erlotinib 150 mg once a day , and after 3 months, the pet scan showed significant reduction in the disease burden and relief from symptoms. She continues to be on targeted therapy and inj zolendronic acid since 18 months ,maintaining a active and good quality of life.
52 year female, non smoker , presented with non healing ulcer on her rt foot, and generalized body ache and fatigue, biopsy revealed malignant melanoma . on further testing PDL1 was positive.
She was started on chemotherapy DTIC + immunotherapy pembrolizumab , and inj zolendronic acid for bony metastasis. She responded well and went into complete metabolic remission after 3 months. She continues to remain in remission after 24 months.
