Pembrolizumab for refractory primary mediastinal B-cell lymphoma with central nervous system involvement

Cristina de-la-Fuente; Fidel Nuñez; Montserrat Cortés-Romera; Mireia Franch-Sarto; Josep-Maria Ribera; Juan-Manuel Sancho

doi:10.1002/hon.2836

Pembrolizumab for refractory primary mediastinal B-cell lymphoma with central nervous system involvement

Hematol Oncol. 2021 Aug;39(3):419-422. doi: 10.1002/hon.2836. Epub 2021 Jan 11.

Authors

Cristina de-la-Fuente¹, Fidel Nuñez², Montserrat Cortés-Romera³, Mireia Franch-Sarto¹, Josep-Maria Ribera¹, Juan-Manuel Sancho¹

Affiliations

¹ Department of Hematology, Institut Català d'Oncologia-Hospital Germans Trias i Pujol, Josep Carreras Research Institute, Badalona, Spain.
² MRI Unit, Institut de Diagnòstic per la Imatge, Hospital Germans Trias i Pujol, Badalona, Spain.
³ Department of PET/CT-Nuclear Medicine (IDI), Hospital de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain.

PMID: 33369766
DOI: 10.1002/hon.2836

Abstract

Primary mediastinal large B-cell lymphoma (PMBCL) is a rare aggressive B-cell lymphoma characterized by the frequent presence of amplification and translocation events at 9p24.1, resulting in the expression of the programmed cell death-1 (PD-1) ligands PD-L1 and PD-L2. Pembrolizumab, a humanized anti-PD-1 monoclonal antibody, binds PD-1 and blocks this interaction, enhancing the activity of the immune system against tumor cells, and has shown activity in PMBCL and in some cases of primary and secondary central nervous system (CNS) lymphoma. We report the case of a 40-year-old woman diagnosed with relapsed PMBCL and secondary CNS involvement who responded to pembrolizumab monotherapy, allowing for a later allogeneic stem cell transplant.

Keywords: CNS relapse; immunotherapy; pembrolizumab; primary mediastinal lymphoma.

Publication types

Case Reports
Letter

MeSH terms

Adult
Allografts
Antibodies, Monoclonal, Humanized / administration & dosage*
B7-H1 Antigen / antagonists & inhibitors
B7-H1 Antigen / genetics
B7-H1 Antigen / metabolism
Central Nervous System Neoplasms / genetics
Central Nervous System Neoplasms / metabolism
Central Nervous System Neoplasms / pathology
Central Nervous System Neoplasms / therapy*
Chromosomes, Human, Pair 9 / genetics
Chromosomes, Human, Pair 9 / metabolism
Female
Humans
Lymphoma, B-Cell / genetics
Lymphoma, B-Cell / metabolism
Lymphoma, B-Cell / pathology
Lymphoma, B-Cell / therapy*
Mediastinal Neoplasms / genetics
Mediastinal Neoplasms / metabolism
Mediastinal Neoplasms / pathology
Mediastinal Neoplasms / therapy*
Membrane Proteins / antagonists & inhibitors
Membrane Proteins / genetics
Membrane Proteins / metabolism
Neoplasm Proteins / antagonists & inhibitors
Neoplasm Proteins / genetics
Neoplasm Proteins / metabolism
Stem Cell Transplantation*
Translocation, Genetic
Tumor Suppressor Proteins / antagonists & inhibitors
Tumor Suppressor Proteins / genetics
Tumor Suppressor Proteins / metabolism

Substances

Antibodies, Monoclonal, Humanized
B7-H1 Antigen
CD274 protein, human
DLG5 protein, human
Membrane Proteins
Neoplasm Proteins
Tumor Suppressor Proteins
pembrolizumab