A 38 year old man with no significant past medical illness presented with progressive multiple neck masses for two months. Biopsy showed diffuse large B-cell lymphoma. Further investigation confirmed he has stage III lymphoma.

A) Name one chemotherapy combination which is commonly used as first line treatment for aggressive non-Hodgkin’s lymphoma. Discuss the mechanism of action of each drug as well as their general and specific adverse effects. (9 marks)

B) Name one targeted therapy which has been demonstrated to improve clinical outcomes of patients with B-cell lymphoma. Discuss its mechanism of action, common and clinically important adverse effects as well as strategies to prevent these adverse affects. (7 marks)

C) How should this be managed if extravasation of cytotoxic agent occurs? (4 marks)