Myositis, polyserositis with a large pericardial effusion and constrictive pericarditis as manifestations of chronic graft-versus-host disease after non-myeloablative peripheral stem cell transplantation and subsequent donor lymphocyte infusion.
The clinical features of chronic graft-versus-host disease (cGVHD) following a non-myeloablative peripheral blood stem cell (PBSC) transplant may differ from those that occur after a conventional allograft. We describe a man with Hodgkin's disease refractory to chemotherapy and radiotherapy who was transplanted from an HLA-identical brother, who developed cGVHD characterised, in particular, by polymyositis, polyserositis with a large pericardial effusion and constrictive pericarditis, 1 month after donor lymphocyte infusion for relapsed disease. Constrictive pericarditis has not been previously reported after a conventional allograft, and none of these features have been reported after a non-myeloablative transplant. The course of cGVHD necessitated potent immunosuppression leading to the presumed loss of graft-versus-lymphoma (GVL) effect.
Department of Haematological Oncology, St Bartholomew's Hospital, London, UK.
L
L
Silberstein
A
A
Davies
S
S
Kelsey
J
J
Foran
C
C
Murrell
D
D
D'Cruz
S
S
Vinnicombe
A
A
Norton
J
J
Cavenagh
D000328:Adult; D002908:Chronic Disease; D006086:Graft vs Host Disease / Q000209:etiology*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006689:Hodgkin Disease / Q000628:therapy; D006801:Humans; D017710:Lymphocyte Transfusion / Q000009:adverse effects*; D008297:Male; D009220:Myositis / Q000209:etiology*; D010490:Pericardial Effusion / Q000209:etiology*; D010494:Pericarditis, Constrictive / Q000209:etiology*; D014184:Transplantation, Homologous