title: Combined immunoradiotherapy induces long-term remission of CNS relapse of peripheral, diffuse, large-cell lymphoma after allogeneic stem cell transplantation: case study.
abstract: 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 The brain was irradiated with 44 Gy, anti-CD20 antibodies were given, and the immunosuppression was withdrawn.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.
authors.affiliation: Internal Medicine C (Hematology and Oncology, Transplant Centre), Ernst-Moritz-Arndt University, Greifswald, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Lotze
authors.forename: Frank
authors.initials: F
authors.lastname: Schüler
authors.forename: William H
authors.initials: WH
authors.lastname: Krüger
authors.forename: Carsten
authors.initials: C
authors.lastname: Hirt
authors.forename: Michael
authors.initials: M
authors.lastname: Kirsch
authors.forename: Silke
authors.initials: S
authors.lastname: Vogelgesang
authors.forename: Christian A
authors.initials: CA
authors.lastname: Schmidt
authors.forename: Gottfried
authors.initials: G
authors.lastname: Dölken
mesh_terms: 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
chemical_list: D000906:Antibodies; D018951:Antigens, CD20