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My Brother Is Diagnosed With Non Hodgkins Lymphoma And Undergone

Posted on Tue, 4 Dec 2018

Question: My Brother is diagnosed with non Hodgkins lymphoma and undergone 6 times chemo. Since a week is having severe leg pain, headache and neck pain. Since two days he is not able to swallow food, what ever he eats it is coming out in liquid form. Doctor advised for Brain MRI and Spine test. Brain MRI came normal. Spine fluid test is attached here. it says Lymphoblasts are of 75%, Is this confirms CNS LYMPHOMA?
These problems are going if we give medication 'DEXA'. They are coming back if we stop giving DEXA. Please suggest what is our course of action to be?

Answered by Dr. Deepak Sundriyal (38 minutes later)

Brief Answer:
Hello. This is cns relapse

Detailed Answer:
Hello dear. I have gone through the details and seen the reports. So its a case of relapse of lymphoma in cns. This is a critical situation and he will require systemic chemotherapy as well as chemotherapy in cns. Once disease is cleared, a transplant should be done.
Hope it is clear.
Thanks and regards
Feel free to ask further

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Deepak Sundriyal (26 minutes later)

Thanks for the reply sir,

We were showing to DR M B XXXXXXX Hemeto oncologist (mumbai). As you suggested they have given a procedure to follow, am attaching the procedure. Currently three chemo's in this procedure also completed. They started with DEXA dose of 16 MG and slowly decreased it and last week they asked to stop it completely. After stopping the DEXA we are seeing the symptoms of Nerve problems again (Serious leg pain, mouth paralysis and not able to close an eye lid). We are in a panic situation again. MRI scan of brain, Pet scan came clean. But nerve problems are coming again and again. Are we doing some thing wrong. Please help us with your suggestions. Do you recommend any thing else ?

Thanks alot.

Answered by Dr. Deepak Sundriyal (22 minutes later)

Brief Answer:
Hello. Dexa is not a long term solution

Detailed Answer:
Hello dear. Dexamethasone is a steroid and not long term solution. Depending upon the physical condition of the patient, chemotherapy needs to be started in appropriate doses along with cns directed chemotherapy.
That is the only solution.
Thanks and regards
Feel free to ask further

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Deepak Sundriyal (18 minutes later)

Sir, We started the chemotherapy and CNS Directed chemotherapy, three chemo's also completed( in addition to 6 chemo's we done two months back). I had attached the procedure that doctor advised(lymphomaprocedure1 and 2 are the attached files). Please share your opinion whether that procedures looks good or not.

Answered by Dr. Deepak Sundriyal (1 hour later)

Brief Answer:
Hello. The treatment looks fine

Detailed Answer:
Hello dear. So the treatment advised looks fine. Please continue with the treatment.
Thanks and regards

Note: For further queries related to kidney problems Click here.

Above answer was peer-reviewed by : Dr. Yogesh D