Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 26, 2023; 11(30): 7432-7439
Published online Oct 26, 2023. doi: 10.12998/wjcc.v11.i30.7432
Diffuse large B-cell lymphoma successfully treated with amplified natural killer therapy alone: A case report
Kenjiro Nagai, Syo Nagai, Yuji Okubo, Keisuke Teshigawara
Kenjiro Nagai, Syo Nagai, Department of Internal Medicine, Medical Corporation Ebino Centro Clinic, Ebino 889-4304, Japan
Yuji Okubo, Keisuke Teshigawara, Department of Internal Medicine, Higashinotoin Clinic, Kyoto 604-8175, Japan
Author contributions: Nagai K and Nagai S contributed to manuscript writing and editing, and data collection; Okubo Y contributed to data analysis; Teshigawara K contributed to conceptualization and supervision; all authors have read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Kenjiro Nagai, MD, Chief Doctor, Internal Medicine, Medical Corporation Ebino Centro Clinic, 1007-4 Uwae, Ebino City, Miyazaki Prefecture, Ebino 889-4304, Japan. ken701n427@gmail.com
Received: July 21, 2023
Peer-review started: July 21, 2023
First decision: September 13, 2023
Revised: September 26, 2023
Accepted: October 8, 2023
Article in press: October 8, 2023
Published online: October 26, 2023
Processing time: 95 Days and 19.9 Hours
Abstract
BACKGROUND

The prognosis of patients with advanced diffuse large B-cell lymphoma (DLBCL) is poor, with a 5-year survival rate of approximately 50%. The mainstay of treatment is multidrug combination chemotherapy, which has been associated with serious side effects. Amplified natural killer (ANK) cell therapy amplifies and activates natural killer (NK) cells to attack only malignant tumors. As ANK cells attack programmed death ligand 1 (PD-L1)-positive tumor cells, ANK therapy is considered effective against adult T-cell lymphoma and malignant lymphoma.

CASE SUMMARY

Herein, we report a case of an older patient with advanced DLBCL who was successfully treated with ANK immunotherapy. A 91-year-old female visited our hospital with sudden swelling of the right axillary lymph node in April 2022. The patient was diagnosed with stage II disease, given the absence of splenic involvement or contralateral lymphadenopathy. ANK therapy was administered. Six rounds of lymphocyte sampling were performed on July 28, 2022. To reduce the occurrence of side effects, the six samples were diluted by half to obtain 12 samples. Cultured NK cells were administered twice weekly. The treatment efficacy was evaluated by performing computed tomography and serological tests every 1 or 2 mo. The treatment suppressed lesion growth, and the antitumor effect persisted for several months. The patient experienced mild side effects. PD-L1 immunostaining was positive, indicating that the treatment was highly effective.

CONCLUSION

ANK therapy can be used as a first-line treatment for malignant lymphoma; the PD-L1 positivity rate can predict treatment efficacy.

Keywords: Diffuse large B-cell lymphoma; Natural killer cells; Immunostaining; Hodgkin's lymphoma; Older adult; Case report

Core Tip: The current patient was programmed death ligand 1 (PD-L1) positive, and the treatment was highly effective. Accordingly, amplified natural killer (ANK) therapy could be employed as a first-line treatment for malignant lymphoma based on the therapeutic efficacy and minimal side effects. Moreover, the PD-L1 positivity rate may serve as a biomarker for predicting the efficacy of ANK therapy.