Abstract
We report the first case of diffuse large B-cell lymphoma (DLBCL) of the stomach displaying CD20-negative relapse after rituximab-containing treatment and the re-appearance of CD20 expression at the second failure. The loss of CD20 expression in B-cell lymphomas relapsing after rituximab is a well-known phenomenon, but its actual impact in DLBCL is difficult to estimate. This paradigmatic case suggests that CD20-expression reappearance after purging of CD20-positive clones with rituximab might be an underestimated occurrence in B-cell lymphomas. Accordingly, every relapse, whenever possible, should be histologically assessed with diagnostic and immunophenotyping purposes.
MeSH terms
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Aged, 80 and over
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Antibodies, Monoclonal / pharmacology
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Antibodies, Monoclonal / therapeutic use*
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Antibodies, Monoclonal, Murine-Derived
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Antigens, CD20 / biosynthesis*
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Antigens, CD20 / drug effects
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Antigens, CD20 / genetics
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Antigens, Neoplasm / biosynthesis*
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Antigens, Neoplasm / drug effects
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Antigens, Neoplasm / genetics
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Antineoplastic Combined Chemotherapy Protocols / therapeutic use
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Combined Modality Therapy
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Cyclophosphamide / administration & dosage
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Epirubicin / administration & dosage
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Fatal Outcome
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Gene Expression Regulation, Neoplastic*
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Humans
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Immunologic Factors / pharmacology
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Immunologic Factors / therapeutic use*
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Immunophenotyping*
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Immunotherapy*
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Lymphatic Irradiation
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Lymphoma, Large B-Cell, Diffuse / metabolism*
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Lymphoma, Large B-Cell, Diffuse / therapy
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Male
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Neoplasm Recurrence, Local / metabolism*
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Neoplasm Recurrence, Local / pathology
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Neoplasm Recurrence, Local / therapy
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Prednisone / administration & dosage
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Rituximab
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Stomach Neoplasms / metabolism*
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Stomach Neoplasms / therapy
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Vincristine / administration & dosage
Substances
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Antibodies, Monoclonal
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Antibodies, Monoclonal, Murine-Derived
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Antigens, CD20
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Antigens, Neoplasm
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Immunologic Factors
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Epirubicin
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Rituximab
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Vincristine
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Cyclophosphamide
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Prednisone