Relapse of high-grade non-Hodgkin's lymphoma after autologous stem cell transplantation: a case successfully treated with cyclophosphamide plus somatostatin, bromocriptine, melatonin, retinoids, and ACTH.
Patients with relapse of high-grade non-Hodgkin lymphoma (NHL) after autologous stem cell transplantation (auto-SCT) generally have a poor prognosis. Only a minority of these patients can be cured by a second myeloablative chemotherapy, and conventional salvage treatments are often associated with severe toxicities. With a combination of cyclophosphamide, somatostatin, bromocriptine, retinoids, melatonin, and ACTH, we already reported 100% global response in 8 patients with relapse of low-grade NHL after single or combined chemotherapy and a therapy-free period of > or = 6 months. This provided the rationale to evaluate the same pharmacological association in a patient with relapse of high-grade NHL after auto-SCT performed 2 years before. The patient was treated for at least 2 months. At the end of this period, if he had stable or responding disease, he received additional 3 months of treatment, and if he was stable or responding after 5 month, he was treated for 3 months and more. After 2 months, patient had a partial response, and after 5 months, he achieved a complete response. Today, 14 months after beginning treatment, patient is in complete remission. Treatment had very good tolerance, and patient carried on at home doing his normal activities. Our result and severe toxicities associated with conventional salvage treatments suggest in a relapse of high-grade NHL after auto-SCT, further clinical trials using the pharmacological association we employed in this case.
Todisco
Mauro
M
ASL 11, Local Health Department of National Health Service, Fermo, Italy. todmau@tin.it
D000324:Adrenocorticotropic Hormone / Q000008:administration & dosage; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001971:Bromocriptine / Q000008:administration & dosage; D003520:Cyclophosphamide / Q000008:administration & dosage; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D008297:Male; D008550:Melatonin / Q000008:administration & dosage; D012008:Recurrence; D012176:Retinoids / Q000008:administration & dosage; D013004:Somatostatin / Q000008:administration & dosage; D033581:Stem Cell Transplantation; D013997:Time Factors; D014182:Transplantation, Autologous; D016896:Treatment Outcome
D012176:Retinoids; D001971:Bromocriptine; D013004:Somatostatin; D003520:Cyclophosphamide; D000324:Adrenocorticotropic Hormone; D008550:Melatonin