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Forum Name: Lymphoma

Question: Diffused Large B Cell Lymphoma


 mokbul - Sun Nov 18, 2007 10:10 am

Patient is a feamle of 52 years diagnoised with diffused large B cell lymphoma in in medistinum with size of over 10cm sideways and 25cm longitudinally. Stage calcualted as 2B.

1st R-CHOP chemo cycle started on 1st Nov but had to warded on 7th dat of 1st cycle for intervenous antibiotics as the patient developed fever of 38 deg C. White blood cell count came down as low as .48 thus/mil despite GSFC (nupogen) injection on 3rd, 4th, 5th & 6 day of 1st chemo cycle. Later found to be tha biopsy operation wound site has got infected. Doctor has to opene up the wound very deep to drain out pus formation and looks like heeling will take more than a month. In that case the patient will be delayed for 2nd chemo cycle for about 1 month than scheduled.

Understnd in no way 2nd cycle of chemo could be administere with such large open wound.

What could be the probable consequences of delayed chemo cycle?
 Dr. Tamer Fouad - Sun Nov 18, 2007 2:30 pm

User avatar Its unfortunate that the patient was in need of drainage at a time like this. The effects of the delay however, will vary in the short run, in terms of complete remission rate and will also depend on her response to subsequent mediastinal radiotherapy. In any case a delay may allow for the tumor to grow, treatment to become less effective and in some cases may affect long term survival. In theory, a prolonged delay may even select more malignant clones that are more resistant to chemotherapy.

It really depends on how sensitive the patient is to her therapy which varies from person to person. Please note that her disease burden (large mediastinal lymphoma) alone makes her prognosis less favorable.

Nothing can be done but to wait and see.

Good luck and best wishes to the patient.

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