Second opinion changes course of treatment for marginal zone lymphoma survivor

When Alexandra Mastrogiuseppe-Cribbin was diagnosed with stage IV marginal zone lymphoma in August 2023, she and her husband, James, were stunned. 

The 60-year-old had shown no symptoms of the rare B-cell lymphoma subtype except for unexpected weight loss. Her regular doctor only discovered the cancer during an annual physical, after noticing some abnormal swelling on the left side of her abdomen. This hard spot turned out to be a severely enlarged spleen.

“It was like somebody dropped a bomb on us,” recalls Alexandra. “I couldn’t stop crying. My previous husband had died of lymphoma 20 years earlier. I just kept thinking about our children.”

Local treatment causes serious side effects

Initially, Alexandra sought treatment near her home outside of Virginia. But the severe side effects she experienced during her first few rounds of chemotherapy — including heart palpitations, debilitating weakness, paralysis in her right arm, and a high fever — prompted the couple to seek a second opinion at MD Anderson.

“That whole experience really scared me. The pain was excruciating,” Alexandra says.

“There was a rash all over her legs, and she couldn’t stand up for more than a few minutes at a time,” James adds. “I had to put a chair in the shower so that Alexandra could sit down.”

Treatment tweaks at MD Anderson significantly reduce side effects

The first order of business was to get a handle on Alexandra’s side effects. So, when she arrived at MD Anderson late last year, lymphoma specialist Ranjit Nair, M.D., examined her, conducted some additional tests, reviewed her medical records and consulted with her local oncologist. Then, he made some treatment recommendations.

First, he suggested tweaking Alexandra’s treatment regimen by removing the targeted therapy drug rituximab from her infusions and continuing with the chemotherapy drug bendamustine by itself. This would help Alexandra’s blood counts recover and hopefully reverse the worst of her side effects. Then, Nair prescribed additional medications for Alexandra to take both before and after her infusions, to reduce or eliminate any remaining discomfort.

“After that, my cancer treatment was much more tolerable,” says Alexandra. “I did still have a few side effects, like monster headaches and fatigue, but they were not nearly as severe.”

“Our consultation with Dr. Nair marked a real turning point,” adds James. “The next couple of months were much easier for Alexandra because of it.”

Alexandra received her last chemotherapy infusion near her home in Virginia on Feb. 5, 2024. She was declared in remission as of March 15, 2024, after both local and MD Anderson doctors reviewed her latest scans. 

Gratitude for MD Anderson’s culture of Caring

Today, the couple remains very grateful for the modifications Nair suggested. This enabled Alexandra to complete her treatments close to home — and ultimately, to reach remission. But it was the sensitivity and compassion they encountered at MD Anderson that the couple appreciated most.

“We were treated like royalty from the moment we arrived,” notes James. “The level of caring we experienced at MD Anderson was truly second to none.”

Health information specialist Alexis Shields made a great first impression before the couple even set foot in Houston. When James called MD Anderson on a Saturday afternoon in October, she stayed on the phone with him for almost an hour, carefully documenting details of Alexandra’s side effects before her first appointment.

Nurse Meaghan O’Brien, physician assistant Hongyan Wang and patient care specialist Maleeta Watson coordinated everything from the quick transfer of Alexandra’s medical records from D.C. to Houston to the couple’s check-in at the Rotary House once their taxi arrived.

And, finally, Nair greeted both James and Alexandra with a hug at their first meeting, then spent more than an hour explaining her condition and answering all of their questions.

“We really believe in the motto, ‘People don’t care how much you know until they know how much you care,’” notes James. “Everyone at MD Anderson clearly abides by this mantra, too, because they show empathy first, then discern the best solution to any problem.” 

“MD Anderson’s expertise is unparalleled,” he adds. “But the human aspect of it is also triple A+. We were very impressed and pleased. So, if, God forbid, this disease should ever return, we plan to head straight back to MD Anderson.”

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