[Remission induction of refractory diffuse large B-cell lymphoma with allogeneic peripheral blood stem cell transplantation followed by interferon-alpha and donor lymphocyte infusion].
Graft-versus-lymphoma (GVL) effect has been described in patients with malignant lymphoma after allogeneic stem cell transplantation (alloSCT). The effect of interferon-alpha (IFN-alpha) on the GVL effect still remains unclear. Here we report on a 29-year-old woman with refractory diffuse large B-cell lymphoma (DLBL). Her clinical findings included multiple masses in the liver, stomach, bilateral kidneys, thyroid, vertebral bones and a bulky mediastinal mass. Since the patient did not respond to various combination chemotherapies and further developed superior vena cava syndrome, allogeneic peripheral blood stem cell transplantation (PBSCT) from a HLA-identical brother was carried out after a myeloablative TBI/CY-based conditioning regimen. DLIs have been also performed every 4 weeks since day +14. As a result, the lymphoma masses showed a partial response. In order to enhance the GVL effect, IFN-alpha was further given at a maximum of 3 MU four times per week. Although the patient only experienced graft-versus-host disease of the skin (grade II) even after both DLIs and IFN, complete clinical remission was observed. 200 days after transplantation, the patient is still disease-free and in good condition. This report suggests the curative potential of IFN-alpha combined with DLI after allogeneic SCT in refractory DLBL.
Kawano
Ichiro
I
First Department of Internal Medicine, University of Occupational and Environmental Health.
Tsukada
Junichi
J
Toda
Yoko
Y
Ogawa
Ryosuke
R
Higashi
Takehiro
T
Iwashige
Atsushi
A
Ota
Takanori
T
Kubota
Ayumu
A
Mizobe
Takamitsu
T
Morimoto
Hiroaki
H
Machida
Shinichiro
S
Tanaka
Yoshiya
Y
D000328:Adult; D005260:Female; D020350:Graft vs Tumor Effect; D006801:Humans; D016219:Immunotherapy, Adoptive; D016898:Interferon-alpha / Q000627:therapeutic use*; D017710:Lymphocyte Transfusion; D016393:Lymphoma, B-Cell / Q000628:therapy*; D008228:Lymphoma, Non-Hodgkin / Q000628:therapy*; D036102:Peripheral Blood Stem Cell Transplantation; D012074:Remission Induction / Q000379:methods*
D016898:Interferon-alpha