title: [Sustained complete remission of intravascular large B-cell lymphoma with recurrent CNS involvement by autologous peripheral blood stem cell transplantation preconditioned with TBC regimen].
abstract: Intravascular large B-cell lymphoma (IVLBCL) is a rare subtype of extranodal large B-cell lymphoma characterized by the growth of lymphoma cells only within the lumina of small vessels in various organs. IVLBCL is an intractable hematological disease, in particular, the high incidence of central nervous system (CNS) involvement is one of the causes of the poor prognosis of IVLBCL. Autologous stem cell transplantation (ASCT) is an effective therapeutic option for refractory or high-risk aggressive lymphoma. However, it is unknown whether ASCT is an effective treatment for CNS involvement of aggressive lymphoma including IVLBCL. We show a case of a 39-year-old woman with recurrent CNS involvement of IVLBCL receiving autologous peripheral blood stem cell transplantation (auto-PBSCT) preconditioned with high-dose thiotepa, busulfan, cyclophosphamide (TBC regimen). Culture-negative febrile neutropenia developed requiring antimicrobial therapy, but nonhematological adverse effects including stomatitis and neurotoxicity, with grade ≥ 3, were not observed. The patient achieved and has maintained complete remission (CR) for 24 months after TBC/auto-PBSCT and has survived for around 30 months from the diagnosis of the CNS recurrence. The clinical course of this case suggests that auto-PBSCT preconditioned with TBC could be one of the therapeutic options for the treatment of CNS involvement of IVLBCL.
authors.affiliation: Department of Hematology, Osaka Red Cross Hospital.
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Miura
authors.forename: Nao
authors.initials: N
authors.lastname: Toyooka
authors.forename: Fumie
authors.initials: F
authors.lastname: Iwai
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Matsui
authors.forename: Mihoko
authors.initials: M
authors.lastname: Hirai
authors.forename: Hitomi
authors.initials: H
authors.lastname: Kaneko
authors.forename: Mitsumasa
authors.initials: M
authors.lastname: Watanabe
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Tsudo
mesh_terms: D000328:Adult; D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D001932:Brain Neoplasms / Q000628:therapy*; D002066:Busulfan / Q000008:administration & dosage; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage; D005260:Female; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000628:therapy*; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local; D036102:Peripheral Blood Stem Cell Transplantation; D012074:Remission Induction; D013852:Thiotepa / Q000008:administration & dosage; D014184:Transplantation, Homologous; D019043:Vascular Neoplasms / Q000628:therapy*
chemical_list: D018906:Antineoplastic Agents, Alkylating; D003520:Cyclophosphamide; D013852:Thiotepa; D002066:Busulfan