Merle is an 82-year-old male who is diagnosed with Diffuse Large B-cell Lymphoma (C83.38). of non-germinal center MUM-1 positive type in terminal ileum and cecal ulcer, along with anemia, hypertension, renal cysts, bradycardia, and leukopenia. His symptoms include shortness of breath, and fatigue. Merle was previously treated with R-mini CHOP, bendamustine/rituximab, gemcitabine/oxaliplatin, but still experienced disease progression and developed thrombocytopenia along with having an acute reaction. Merle’s recent PET scan shows disease progression, therefore needs a more combative therapy. Although Merle suffers from diffuse large B cell lymphoma and Imbruvica is not FDA approved for this treatment, the FDA does state “it’s labeling is…show more content… BTK is critical to the growth and survival of B-cells, the type of immune system cells affected in 85 percent of Non Hodgkins Lymphoma. By preventing BTK from functioning, ibrutinib kills the malignant B-cells but, unlike many current NHL therapies, leaves the healthy T-cells in the immune system largely unaffected. This enables a patient to remain healthier during treatment, increasing their chances for long-term survival. The overall response rate to treatment was 71 percent, and two patients achieved a complete response. Response to treatment also proved to be long-lasting; an estimated 75 percent of patients reached 26 months of progression-free survival. Please see the additional research I have enclosed in regards to Imbruvica and the treatment of diffuse large B cell lymphoma. Medication should be made readily available if the medication and it expected results will extend and/or improve the patient’s quality of life. The use of drugs for indications beyond those stipulated in the FDA label has been a physician prerogative that the FDA has approved of for more than 30 years, therefore Imbruvica is Merle’s best treatment option at this time. Without this treatment, I fear his condition will continue to progress causing increased pain and suffering with a potentially fatal
