Combined immunoradiotherapy induces long-term remission of CNS relapse of peripheral, diffuse, large-cell lymphoma after allogeneic stem cell transplantation: case study.
Relapse of peripheral non-Hodgkin's lymphoma (NHL) in the central nervous system commonly has a poor prognosis. Graft-versus-leukemia effects (GvL) contribute substantially to eradication of hematological malignancies after allogeneic stem cell transplantation. Few data are available describing GvL activity within the brain. We report the case of a man allografted for peripheral NHL. On day +83 after transplantation a CNS relapse of the lymphoma occurred. The brain was irradiated with 44 Gy, anti-CD20 antibodies were given, and the immunosuppression was withdrawn. Subsequently, limited-stage, chronic graft-versus-host disease occurred. The lymphoma regressed completely, and the patient has been in continuous complete remission for 30 months. The favorable course suggests substantial contribution of immunomodulation to excellent outcome.
Lotze
Christian
C
Internal Medicine C (Hematology and Oncology, Transplant Centre), Ernst-Moritz-Arndt University, Greifswald, Germany.
Schüler
Frank
F
Krüger
William H
WH
Hirt
Carsten
C
Kirsch
Michael
M
Vogelgesang
Silke
S
Schmidt
Christian A
CA
Dölken
Gottfried
G
D000328:Adult; D000906:Antibodies / Q000627:therapeutic use*; D018951:Antigens, CD20 / Q000276:immunology; D001932:Brain Neoplasms / Q000276:immunology / Q000473:pathology / Q000532:radiotherapy*; D020544:Graft vs Leukemia Effect / Q000502:physiology*; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000276:immunology / Q000473:pathology / Q000532:radiotherapy*; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000276:immunology / Q000473:pathology / Q000532:radiotherapy; D033581:Stem Cell Transplantation
D000906:Antibodies; D018951:Antigens, CD20