My father was diagnosed with Stage IV, CD10 positive, Diffuse Large B-Cell Lymphoma (DLBCL) in November of 2003. After his initial diagnosis, he received 8 cycles of RCHOP as well as Intrathecal Methotrexate (a low-dose chemotherapy drug that prevents cancerous cells entering the cerebrospinal fluid around the spine and brain) under the care of his oncologist at Cornell in NYC. My dad was 45 years old and otherwise very healthy. My father was thankfully very receptive to chemotherapy and went into remission. During this process, we also received an alternate opinion from Memorial Sloan Kettering where he was recommended a bone marrow transplant to prolong remission. We decided against the transplant given the severity of side effects and continued treatment at Cornell.
My dad had a recurrence of Follicular grade 2 Lymphoma in 2006. This is very different than DLBCL. It’s much less aggressive and slower growing. He was treated with Rituximab followed by Rituximab maintenance every 6 months for 12 years. Rituximab maintenance is not standard treatment, and most oncologists would recommend against this, yet something seemed to be working. Since he was tolerating it well, we decided to continue with this as a “preventative” precaution.
In December of 2017, he developed a chest wall mass. The MRI and needle biopsy confirmed it was CD10, BCL6 and BCL2 positive indolent B-cell lymphoma (not the same as the aggressive large B-cell lymphoma). He received radiation to the chest wall and continued Rituximab maintenance.
In 2019, my parents relocated to Florida and under the direction of his new oncologist at MD Anderson, Jacksonville, he stopped Rituximab maintenance. Note, even the head of the department at Cornell, where my father was previous treated, was never on board with Rituximab as a maintenance drug.
In April 2021, my dad started experiencing pain in his elbow, interestingly a few weeks after receiving the J&J Covid-19 vaccine. The MRI showed large mass-like signal abnormality. A core needle biopsy of the elbow lesion was consistent with CD20 negative Diffuse Large B-cell lymphoma (DLBCL). We were shocked and devastated to learn it was DLBCL as we were told that it’s very rare for this kind of cancer to return after being dormant for so long.
