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.
Division of Hematology and Bone Marrow Transplantation, Chinese PLA General Hospital, Beijing, P.R. China.
This article was published in the following journal.
Name: Annals of transplantation : quarterly of the Polish Transplantation Society
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.
General term for inflammation of adipose tissue, usually of the skin, characterized by reddened subcutaneous nodules.
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.
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