CD20-Negative Primary Bone Marrow Large B Cell Lymphoma: A Report of Two Cases with Review of Literature

 

 Permissions and Reprints

Abstract

We describe diagnostic and therapeutic challenges in this rare entity of CD20-negative B cell lymphomas. They comprise only 1 to 2% of all B cell lymphoma with four subcategories. However, with an increasing understanding of these cases, novel entities have been recognized. Workup, treatment, and follow-up of two CD20-negative B cell lymphoma cases, including a novel entity, have been described. A novel case of triple expresser CD20-negative B cell lymphoma and plasmablastic lymphoma has been diagnosed. The absence of CD20 leads to the abolishment of the targeted drug (rituximab) from the treatment regimen. These cases render the importance of extensive immunohistochemistry and fluorescence in situ hybridization workup for diagnosis of this rare entity. Treatment also remains a challenge as immunotherapy with CD20-targeted drugs cannot be given.

Consent

Consent was obtained from patients to use their case for publication.

Publication History

Article published online:
24 August 2023

© 2023. MedIntel Services Pvt Ltd. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

• References

• 1 Castillo JJ, Chavez JC, Hernandez-Ilizaliturri FJ, Montes-Moreno S. CD20-negative diffuse large B-cell lymphomas: biology and emerging therapeutic options. Expert Rev Hematol 2015; 8 (03) 343-354
  CrossrefPubMedGoogle Scholar
• 2 Garg M, Lee BE, McGarry K, Mangray S, Castillo JJ. CD20-negative diffuse large B-cell lymphoma presenting with lactic acidosis. Am J Hematol 2015; 90 (03) E49-E50
  CrossrefPubMedGoogle Scholar
• 3 Tedder TF, Streuli M, Schlossman SF, Saito H. Isolation and structure of a cDNA encoding the B1 (CD20) cell-surface antigen of human B lymphocytes. Proc Natl Acad Sci U S A 1988; 85 (01) 208-212
  CrossrefPubMedGoogle Scholar
• 4 Grillo-López AJ, White CA, Dallaire BK. et al. Rituximab: the first monoclonal antibody approved for the treatment of lymphoma. Curr Pharm Biotechnol 2000; 1 (01) 1-9
  CrossrefPubMedGoogle Scholar
• 5 Evans SS, Clemmons AB. Obinutuzumab: a novel anti-CD20 monoclonal antibody for chronic lymphocytic leukemia. J Adv Pract Oncol 2015; 6 (04) 370-374
  PubMedGoogle Scholar
• 6 Gupta IV, Jewell RC. Ofatumumab, the first human anti-CD20 monoclonal antibody for the treatment of B cell hematologic malignancies. Ann N Y Acad Sci 2012; 1263: 43-56
  CrossrefPubMedGoogle Scholar
• 7 Dunleavy K, Pittaluga S, Shovlin M. et al. Phase II trial of doseadjusted EPOCH in untreated systemic anaplastic large cell lymphoma. Haematologica 2016; 101 (01) e27-e29
  CrossrefPubMedGoogle Scholar
• 8 Linder K, Gandhiraj D, Hanmantgad M, Seiter K, Liu D. Complete remission after single agent blinatumomab in a patient with pre-B acute lymphoid leukemia relapsed and refractory to three prior regimens: hyperCVAD, high dose cytarabine mitoxantrone and CLAG. Exp Hematol Oncol 2016; 5: 20
  CrossrefPubMedGoogle Scholar
• 9 Katchi T, Liu D. Diagnosis and treatment of CD20 negative B cell lymphomas. Biomark Res 2017; 5: 5 DOI: 10.1186/s40364-017-0088-5.
  CrossrefPubMedGoogle Scholar