May 09, 2013 - 4:58 am
I am new to the forum having not posted previously. My husband (39 yrs at diagnosis) was diagnosed with Stage 4B DLBCL Non-Hodgkins in May 2012. He underwent 6 rounds of RChop with 2 additinal rounds of rituximab and 4 x IT meths (as a prophalactic because he was high risk of a relapse and also CD5+). He achieved completed remission in September and had been doing really well until he complained of severed upper abdominal pain at the end of March, they diagnosed diseased gall bladder and gallstones. A cat scan showed slightly enlarged lymphnodes near the bile duct but nothing suspicous. They then did an MRCP which revealed a stricture that appeared to be something pressing on the bile duct causing blockage and jaundice. They inserted a stent to releive the blockage and this worked, after a number of benign biopsies inside the bile duct they eventually found lymphoma cells in the lymph nodes outside the bile duct. They then confirmed a relapse of b cell but can't yet identify the subtype. His ldh this time round is about 300 compared to 1000+ last year but his liver enzyme ALT has shot up from 175 on the 3rd May to 700 yesterday. They put him on steroids by infusion which reduced the inflammation but not the lymphoma. They had planned on giving him RICE but due to liver being impacted they can't give him this regime, it is too risky. Instead they are giving him Rechap (with a lower dose of etoposide to prevent further liver damage). They had hoped to remove the stent before giving chemo but could not do this. He has no pain and is well otherwise. They are also considering allogenic stem cell if they can find a sibling match but I presume this would depend on how he responds to Rechap. Very frustrated that the steroids did not have the impact they did last year when he was first diagnosed and wondering now what this means. Does anyone have a similar type story or any advice to offer if this regime doesn't work?