Durable remission in a patient with refractory subcutaneous panniculitis-like T-cell lymphoma relapse after allogeneic hematopoietic stem cell transplantation through withdrawal of cyclosporine.
Summary of "Durable remission in a patient with refractory subcutaneous panniculitis-like T-cell lymphoma relapse after allogeneic hematopoietic stem cell transplantation through withdrawal of cyclosporine."
Background: Subcutaneous panniculitis-like T-cell lymphoma (SPTCL) is an uncommon subtype of peripheral T-cell lymphoma and its standard treatment remains ongoing study. Cases refractory to chemotherapy are suggested to benefit from autologous hematopoietic stem cell transplantation (auto-HSCT). Nevertheless, post auto-HSCT recurrence seems to be irreversible. Very few cases of allogeneic-HSCT (allo-HSCT) in SPTCL have been reported so far. Case Report: A 27-year-old female presented to our hospital with refractory SPTCL for receiving auto-HSCT. Cutaneous biopsy had confirmed diagnosis of SPTCL at a local hospital, where 5 lines and 10 cycles of intensive chemotherapy had been prescribed. All these treatment provided marginal control of disease progression. After her enrollment at our institute, she relapsed again after the collection of peripheral hematopoietic stem cells. Then, we performed an allo-HSCT to her from a 10/10 matched unrelated donor. Neutrophil and platelet engraftment occurred at day +11 and +13, respectively. At day +15, lymphoma, however, came back, resulting in the withdrawal of cyclosporine from day +35 to day +75, when acute graft versus host disease (aGvHD) emerged. Lymphoma cells were observed in a subcutaneous biopsy from her leg. Eventually, skin manifestation of extensive chronic GvHD developed. By present, the patient has sustained complete remission for 18 months. Conclusions: Allo-HSCT is rational for patients with refractory SPTCL. To our knowledge, this is the first case, with regained remission after post allo-HSCT relapse through cyclosporine withdrawal, showing the existence of graft versus lymphoma (GvL) effect in SPTCL.
Affiliation
Division of Hematology and Bone Marrow Transplantation, Chinese PLA General Hospital, Beijing, P.R. China.
Journal Details
This article was published in the following journal.
Name: Annals of transplantation : quarterly of the Polish Transplantation Society
ISSN: 1425-9524
Pages: 135-8
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/21959522
- DOI: http://dx.doi.org/
Medical and Biotech [MESH] Definitions
Panniculitis, Nodular Nonsuppurative
A form of panniculitis characterized by recurrent episodes of fever accompanied by the eruption of single or multiple erythematous subcutaneous nodules on the lower extremities. They normally resolve, but tend to leave depressions in the skin. The condition is most often seen in women, alone or in association with other disorders.
Panniculitis
General term for inflammation of adipose tissue, usually of the skin, characterized by reddened subcutaneous nodules.
Remission Induction
Therapeutic act or process that initiates a response to a complete or partial remission level.
Panniculitis, Lupus Erythematosus
A type of lupus erythematosus characterized by deep dermal or subcutaneous nodules, most often on the head, face, or upper arms. It is generally chronic and occurs most often in women between the ages of 20 and 45.
Anemia, Refractory, With Excess Of Blasts
Chronic refractory anemia with granulocytopenia, and/or thrombocytopenia. Myeloblasts and progranulocytes constitute 5 to 40 percent of the nucleated marrow cells.
PubMed Articles
Histopathology of panniculitis - aspects of biopsy techniques and difficulties in diagnosis.
Background: Clinical and histologic diagnosis of panniculitis may be difficult. The patients usually present with erythematous subcutaneous nodules with or without additional symptoms. If a skin biops...
Acinar cell carcinoma of the pancreas associated with subcutaneous panniculitis.
Acinar cell carcinoma is a rare pancreatic malignant tumor, which can be associated with a particular manifestation: pancreatic panniculitis. It presents with erythematous subcutaneous nodules located...
We report a patient with the extremely rare familial multiple lipomatosis syndrome, who developed the uncommon autoimmune disease cytophagic histiocytic panniculitis, manifested as inflammation of pre...
Demonstration of T-cell receptor gene monoclonality often plays an important role in the diagnosis of T-cell lymphoma. When a test to detect monoclonality is performed on whole tissue sections, the pr...
Clinical Trials
Study of Cordycepin Plus Pentostatin in Patients With Refractory TdT-Positive Leukemia
This is a two-part, open-label, Phase I/II study in subjects with relapsed or refractory TdT-positive leukemia for which no standard therapies are expected to result in durable remission.
Part 1 of this trial will assess the safety and effectiveness of subcutaneous (SC) golimumab administered by autoinjector once monthly, when combined with different disease-modifying antir...
Subcutaneous Recombinant Human Hyaluronidase: Workflow Analysis and Emergency Department Design
This is an observational study examining the workflow dynamics and training requirements that support effective use of subcutaneous hydration delivery (a newly FDA approved Baxter product)...
The purpose of this study is to investigate and evaluate the effects of different interventions (1.continuous subcutaneous insulin infusion,2.continuous subcutaneous insulin infusion combi...
Thalidomide in Pediatric Inflammatory Bowel Diseases.
Several open-label studies reported thalidomide efficacy in inducing clinical remission and steroid tapering in refractory Inflammatory Bowel diseases (IBD), both in adults and in children...
