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Diagnosed positive for malignancy. Normocellular normoblastic maturation found in bone marrow. Looking for second opinion

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General & Family Physician
Practicing since : 1978
Answered : 6714 Questions
Hello Doctor,
My father is diagnosed positive for malignancy, metastatic deposits of carcinoma from biopsy from inguinal and right iliac lymphnode.
It is further diagnosed as NHL; B-cell type
in Bone marrow trephine biopsy - normocellular normoblastic maturation found
PET-CT evaluation as follows:
Multiple enlarged right external iliac, right inguinal, few small precaval, aortocaval, retrocaval and right XXXXXXX iliac nodes - s/o lymphomatous involvement + few tiny precarinal, pretracheal and right hilar nodes noted with mild FDG uptake - ? lymphomatous involvement / reactive nodes

IHC Marker analysis:
Ki67 60-70% of cells are positive
CD3 shows positivity in T lymphocytes. Negative in large atypical cells

Doctors suggested R-CHOP as treatment for this.
I would like to knw whether this is the correct treatment for this and how many cycles are needed for this.

Thanks and regards,

Posted Fri, 3 Aug 2012 in Lymphoma
Answered by Dr. Pavan Kumar Gupta 34 minutes later
Thanks for the query.
R-CHOP seems to be the right choice for treatment of NHL in your father.
R-CHOP is the abbreviated name of a cobination of drugs used in chemotherapy for aggressive Non-Hodgkin Lymphomas (NHL). It is a relatively new combination which adds the drug Rituximab - a monoclonal antibody, to the standard combination called CHOP. CHOP consists of four chemotherapy drugs.

Cyclophosphamide, an alkylating agent which damages DNA by binding to it and causing cross-links
Hydroxydaunorubicin (also called doxorubicin or Adriamycin), an intercalating agent which damages DNA by inserting itself between DNA bases
Oncovin (vincristine), which prevents cells from duplicating by binding to the protein tubulin

Rituximab is administered as an infusion over a few hours on the first day of treatment, while the drugs of the CHOP regimen may be started the next day. The entire course is usually repeated every three weeks for 6-8 cycles.

R-CHOP is now considered a standard chemotherapy regimen for Diffuse Large B-Cell Lymphoma (BLBCL), the commonest type of Non-Hodgkin Lymphoma.

In case you have any other query, I will be happy to answer that.
Best of luck
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