International Summit on Hematology and Blood Disorders

April 27-29, 2023

April 27 -29, 2023 | Online Event
Hematology 2023

Lilija Bancevica

Lilija Bancevica, Speaker at Hematology Conferences
Riga Stradins University, Latvia
Title : Histologic transformation of mantle zone lymphoma to diffuse large B-Cell lymphoma: A case report of disease relapse after Covid-19 infection


Introduction: Mantle cell lymphoma is a rare subtype of non-Hodgkin’s lymphoma, which may develop into other subtypes, such as diffuse large B-cell lymphoma, which is the most common among all non-Hodgkin's lymphomas. Usual clinical features of diffuse large B-cell lymphoma include quickly growing, non-painful mass, enlarged lymph nodes in the neck, groin and/or abdomen, fever, night sweats, weight loss. Current data of COVID-19 infection risk and outcome in patients with nonHodgkin's lymphoma, receiving chemotherapy and immunosuppression treatment, is variable and insufficient. We report a case of histologically confirmed transformation of mantle zone lymphoma to diffuse large B-cell lymphoma, the disease relapse after COVID-19 infection.

Case description: We present a 58-year-old female patient, who had a history of abdominal pain episodes associated with fever, diarrhea and nausea in 2017. Biopsy of colon revealed mantle cell lymphoma. Patient received polychemotherapy courses with Rituximab, Cyclophosphamide, Vincristine, high dose Cytarabine and Cisplatin. In the 2020 disease relapsed. Therapy with Rituximab and Bendamustine was continued. In 2021 disease relapsed again and lymphoma’s transformation to diffuse large B-cell lymphoma was histologically confirmed. After the high dose chemotherapy (Rituximab, high dose Cytarabine and Cisplatin), autologous stem cell transplantation was performed. The Moderna vaccine against COVID-19 was received twice. Positron emission tomography showed complete metabolic remission. 6 months prior to case presentation diffuse large B-cell lymphoma has relapsed after COVID-19 infection, which was diagnosed in February 2022. The patient received Remdesivir antiviral therapy, followed by specific therapy courses with Rituximab, Bendamustine and Polatuzumab. COVID-19 infection returned in July 2022. Lymphoma dynamic was negative. Chemotherapy was changed to Vinblastine, Cyclophosphamide and Bleomycin – with a positive effect. Overall patient condition at present is dynamically positive.

Conclusions: In this report, we show a patient with diffuse large B-cell lymphoma setback after COVID-19 infection. Even after antiviral therapy COVID-19 patients with hematologic malignancies may have prolonged active infection with impaired viral excretion.

Summary: Current study demonstrates a case of multiple lymphoma relapses with following chemotherapy courses, COVID-19 infection setbacks after vaccine due to intense immunosuppression

Keywords: Mantle cell lymphoma, diffuse large B-cell lymphoma, COVID-19, chemotherapy.


I am 4th year medical student at Riga Stradins University, Latvia. I have been enthusiastic about hematology and oncology starting from second studying year at medical school, being myself diagnosed with rare hematological disease and receiving a stem cell transplant as a cure. I have also been into volunteering, working and researching in the field of hematology and oncology since finishing 2nd studying year at Medical Faculty. I have been into research in the fields of human anatomy, pediatric and adult oncology, in 2022 participated at Riga Stradins University International Medical Student Conference with two research papers about adolescent osteosarcoma clinical case, where was awarded with 1st place among all pediatric case reports and 2nd place among all surgery case reports. Currently I am doing research about mantle cell lymphoma transformation to diffuse large B-cell lymphoma and am going to participate with it in Riga Stradins University International Medical Student Conference 2023.

I would be glad to continue my contribution to hematology and oncology field improvement and development in Latvia, as well as abroad my country. It would be crucial to share my experience about oncology field development and treatment options in coutries abroad, as well as improve my own education in the field of oncology.