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Primary mediastinal large B‐cell lymphoma


Primary mediastinal B‐cell lymphoma (PMBL) is a distinct subtype of diffuse large B‐cell lymphoma (DLBCL) arising from putative thymic B‐cells in the mediastinum and comprises 2–4% of all non‐Hodgkin lymphomas (NHLs) (Gaulard et al, 2008) – therefore it’s relatively rare, and has only recently (since Oct 2015) been treated as a separate entity, both diagnostically and therapeutically; concise information is scattered around and limited to very specific communities, hematology magazines and websites.

As the parents from Croatia whose teenage son was diagnosed with PMBCL, we wanted to make a single point of reference with all the recent articles (up to 2019) that we had found on diagnosis, various treatment regimens and post-treatment. 

Disclaimer: The content of this non-commercial website is for information purposes only. Information provided here shouldn’t and mustn’t be used as a replacement or an alternative to an official, expert MD opinion. All the links are publicly available, unless specified differently.



All the recent articles (up to December 2019) that we had found on diagnosis, various treatment regimens and post-treatment. 

2005 Reiter et al.

2010 Bilic et al.

2010 Algrin et al.

2011 Pohlen et al.

2012 Prahladan et al.

2013 Dunleavy et al.

2013 Woesmann et al.

2013 Itti et al.

2014 Dabrowska-Iwanicka et al.

2014 Avivi et al.

2014 Martelli et al.

2014 Prochazka et al.

2014 Romejko-Jarosinska et al.

2014 Nagle et al.

2015 El Mallawany et al.

2015 Tavares et al.

2015 Svoboda et al.

2015 Vassilakopoulos et al.

2015 Dunleavy et al.

2015 Duehrsen et al.

2015 Pinnix et al.

2015 Gleeson et al.

2015 Petkovic

2015 Burke et al.

2015 Reiter et al.

2015 Aoki et al.

2016 Hochberg et al.

2016 Kocurek et al.

2016 Filippi et al.

2017 Kahn et al.

2017 Adams et al.

2017 Dunleavy

2017 Giulino-Roth et al.

2017 MD Anderson Center, Texas University

2017 Ceriani et al.

2017 Zinzani et al.

2017 Younes et al.

2017 Barrington et al.

2017 Shah et al.

2017 Savage et al.

2018 Pinnix et al.

2018 Melani et al.

2018 Dunleavy et al.

2018 Broccoli et al.

2018 Ceriani et al.

2018 Giulino-Roth

2018 Vardhana et al.

2018 Messmer et al.

2018 Avivi

2018 Michalarea et al.

2018 Avivi et al.

2019 Lees et al.

2019 Cwynarski et al.

2019 Tomassetti et al.

Our Story

Real-life case

March 2019


16yr old male, accidental finding of mediastinal mass (X-rayed, and then confirmed by MR). Pre-therapy PET-CT provided baseline data: mass dimensions (i.e. volume), disease spread and SUVmax. Thoracic biopsy has confirmed PMBCL (including the 2nd opinion).

April 2019


Before chemo, potential sterility side effects and sperm bank was discussed 

April 2019

Starting treatment

Treatment was performed based on B-NHL BFM-04 protocol – 6 chemotherapy cycles + Rituximab (MabThera) with intrathecal methotrexate in each cycle, with 21-26 days between cycles (1st day to 1st day)

Various side effects were expected and observed during and after each chemotherapy cycle (high blood pressure, fever, liver issues, changes in blood parameters…)

June 2019

Interim PET-CT

After 3 cycles, interim PET-CT was performed, results (dimensions and SUVmax) assessed according to Deauville scale

August 2019

Stem cells harvested

Between chemo cycle 5 and cycle 6, stem cells were harvested from peripheral blood

August 2019

Chest MRI

After 5 cycles, MR was performed to check on mediastinal mass regression

September 2019

Additional 2 doses of Rituximab

After 6 cycles and the multidisciplinary assessment, it was agreed to continue with 2 additional cycles of Rituximab (21-26 days between cycles), and PET/CT is to be performed 4-6 weeks after the last dose of Rituximab. 

September 2019

Chest MRI

In order to check the mediastinal mass regression, it was agreed to perform the control MR between Rituximab cycles 7 and 8.

November 2019

Control PET-CT

After 8 cycles, final PET-CT was performed, results (dimensions and SUVmax) assessed according to Deauville scale. Remission confirmed.