RARE CASE, UNIQUE THERAPY: HOW MARGINAL ZONE LYMPHOMA WAS DEFEATED

Specialists of the High-Dose Therapy Department of the P. Hertsen Moscow Oncology Research Institute (MORI) – branch of the National Medical Research Radiological Centre of the Ministry of Health of the Russian Federation, regularly treat patients with various forms of non-Hodgkin’s lymphoma. This time they had to deal with a clinically atypical and relatively rare variant of the disease – marginal zone lymphoma.

Two years ago, Oksana developed swelling and pain in her left leg. The symptoms gradually increased, which finally forced her to seek medical help. The conducted examinations – magnetic resonance imaging (MRI) and computed tomography (CT scan) – revealed a volumetric neoplasm in the pelvic cavity. It muft-like encompassed the left external and partially iliac vessels, tightly adjoining the left ovary and bladder.

A comprehensive follow-up examination, conducted at our Center on the referral of Donetsk colleagues, allowed to clarify the nature of the disease. The diagnosis was non-Hodgkin’s malignant lymphoma, a tumor of lymphoid nature, predominantly affecting lymph nodes.

The specialists of the P. Hertsen Moscow Oncology Research Institute, also performed immunomorphological analysis of the tumor cells and stated that there was no breakage (or, as doctors say, rearrangement) of the BCL2 gene, which means that we can hope for a good response to the R-CHOP treatment. This is a special multi-component regimen that includes chemohormonal and immune drugs that target tumor cells.

“Despite her extremely serious condition – at the time of admission Oksana had difficulty even moving around – she kept an amazing inner calmness, smiled constantly and, as it is now customary to say, remained positive. She unconditionally believed in success,” says Alevtina Chervontseva, an attending hematologist at the High-Dose Therapy Department. – In our work it is of great importance. Over more than twenty years of practice, I have noticed that patients with such a life-affirming attitude, as a rule, undergo treatment once – and never return. Optimists recover.

The course of therapy, selected by the specialists of the department under the guidance of Maria Vernyuk, PhD, was as effective as possible: a complete metabolic response was achieved. In other words, the body gave a pronounced positive response to the treatment, confirmed by PET/CT data.

The tumor, which previously was a dense formation surrounding the pelvic vascular structures, was transformed into a low-structured soft tissue formation with no signs of active metabolism. Its volume was reduced by more than two times. External and iliac vessels, as well as adjacent lymph nodes were freed from compression, which gave tangible clinical improvement – swelling and pain disappeared, limb function was restored.

Of course, this is not the final story of the patient from Mariupol. Now Oksana will have to undergo regular check-ups, as with any other chronic disease.

As a token of gratitude for her care and support, Oksana presented her doctor with a warm, personal gift – a doctor doll made by her own hands. This touching souvenir became not only a symbol of the road traveled, but also a reminder of the power of trust between patient and doctor.