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Allogeneic hematopoietic stem cell transplantation for peripheral T cell lymphomas; evidence of graft-versus-T cell lymphoma effect.
| Content Provider | Semantic Scholar |
|---|---|
| Author | Hamadani, Mehdi Awan, Farrukh T. Elder, Patrick Lin, Thomas S. Porcu, Peirluigi Blum, Kristie A. Devine, Steven M. |
| Copyright Year | 2008 |
| Abstract | skin rash resolved, and an MP taper was started. Three weeks later (July 24, 2007) his MP dose was down to 32 mg/day. On August 1, 2007, a follow-up FDG PETCT scan on that day showed dramatic and complete resolution of the tracer uptake in the multifocal marrow-based lesions as well as resolution of his retroperitoneal adenopathy. The lytic lesions in the marrow demonstrated interval calcification in keeping with response to treatment (Figure 1B). At that time, he was receiving low-dose MP (8 mg/day), tacrolimus (1 mg every other day), and weekly extracorporeal photopheresis. A follow-up bone marrow biopsy (August 17, 2007) showed a hypocellular marrow and no evidence of HL infiltration. At that time the patient's MP dose had been further reduced to 4 mg/day. At his latest follow-up (October 2, 2007), his HL remains in clinical remission. His MP dose remains 4 mg/day, and his tacrolimus dose is 0.5 mg every other day. We believe this case provides vivid, objective documentation that a powerful graft-versus-HL effect exists even in patients with disseminated and extensive disease (including marrow involvement), albeit overlapping in this case with severe skin and hepatic GVHD. Although it cannot entirely be ruled out that steroid therapy started for GVHD may have contributed to the most recent response, this patient was known to have advanced, highly refractory disease. Such a rapid and generalized response to single-agent methylprednisolone is unlikely. In addition, his methylprednisolone dose was quite low at the time of his FDG PET-CT restaging and repeat marrow biopsy, and his overall clinical course supports the presence of a graft-versus-HL effect. The immunologic mechanisms underlying this effect are not clear. Whether and how this effect can be harnessed and modulated in a more selective and clinically useful fashion deserves further study. |
| File Format | PDF HTM / HTML |
| DOI | 10.1016/j.bbmt.2008.01.002 |
| PubMed reference number | 18342792 |
| Journal | Medline |
| Volume Number | 14 |
| Issue Number | 4 |
| Alternate Webpage(s) | https://core.ac.uk/download/pdf/82376808.pdf |
| Alternate Webpage(s) | https://doi.org/10.1016/j.bbmt.2008.01.002 |
| Journal | Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation |
| Language | English |
| Access Restriction | Open |
| Content Type | Text |
| Resource Type | Article |
