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Regression of intestinal diffuse large B cell lymphoma after treatment with vedolizumab in a patient with Crohn's disease

Published:October 15, 2022DOI:https://doi.org/10.1016/j.ejca.2022.09.015
      Vedolizumab is a humanized immunoglobin G1 monoclonal antibody that binds the gut homing receptor α4β7 integrin and inhibits its ability to bind mucosal addressin cell adhesion molecule-1, which is expressed on the endothelium within the gut-associated lymphoid tissues and mesenteric lymph nodes (MLN) [
      • Soler D.
      • Chapman T.
      • Yang L.L.
      • Wyant T.
      • Egan R.
      • Fedyk E.R.
      The binding specificity and selective antagonism of vedolizumab, an anti-alpha4beta7 integrin therapeutic antibody in development for inflammatory bowel diseases.
      ]. Therefore, vedolizumab prevents lymphocytes from extravasating into gastrointestinal mucosal tissues and regional lymph nodes, thus attenuating intestinal inflammation [
      • Soler D.
      • Chapman T.
      • Yang L.L.
      • Wyant T.
      • Egan R.
      • Fedyk E.R.
      The binding specificity and selective antagonism of vedolizumab, an anti-alpha4beta7 integrin therapeutic antibody in development for inflammatory bowel diseases.
      ]. The efficacy of vedolizumab for inflammatory bowel disease was demonstrated in patients with ulcerative colitis [
      • Feagan B.G.
      • Rutgeerts P.
      • Sands B.E.
      • Hanauer S.
      • Colombel J.F.
      • Sandborn W.J.
      • et al.
      Vedolizumab as induction and maintenance therapy for ulcerative colitis.
      ] and Crohn’s disease (CD) [
      • Sandborn W.J.
      • Feagan B.G.
      • Rutgeerts P.
      • Hanauer S.
      • Colombel J.F.
      • Sands B.E.
      • et al.
      Vedolizumab as induction and maintenance therapy for Crohn's disease.
      ]. We describe a case of primary gastrointestinal diffuse large B cell lymphoma (DLBCL) in which vedolizumab induced complete metabolic remission.
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