Successful pseudo-autologous stem cell transplantation for donor-derived Burkitt lymphoma occurring 9 years after allogeneic transplantation

Donor-derived hematological malignancies have been recognized as rare but serious late complications in allogeneic hematopoietic stem cell transplantation (allo-HSCT) recipients. Most cases in the literature were diagnosed as myelodysplastic syndrome or acute leukemia, with very few malignant lympho...

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Bibliographic Details
Published in:International journal of hematology 2023-02, Vol.117 (2), p.287-292
Main Authors: Taniguchi, Shiho, Utsumi, Sae, Kochi, Yu, Taya, Yuki, Mori, Yasuo, Semba, Yu-ichiro, Sugio, Takeshi, Miyawaki, Kohta, Kikushige, Yoshikane, Kunisaki, Yuya, Yoshimoto, Goichi, Numata, Akihiko, Kato, Koji, Uchida, Naoyuki, Maeda, Takahiro, Miyamoto, Toshihiro, Taniguchi, Shuichi, Akashi, Koichi
Format: Article
Language:English
Subjects:
Allografts
Autografts
Burkitt Lymphoma - etiology
Burkitt Lymphoma - therapy
Burkitt's lymphoma
Case Report
CD34 antigen
Chemotherapy
Complications
Graft vs Host Disease - diagnosis
Graft vs Host Disease - etiology
Graft vs Host Disease - pathology
Graft-versus-host reaction
Hematology
Hematopoietic Stem Cell Transplantation - adverse effects
Hematopoietic stem cells
Humans
Immunosuppressive Agents
Leukemia
Leukemia, Myeloid, Acute - complications
Lymphoma
Lymphoma - complications
Malignancy
Medicine
Medicine & Public Health
Myelodysplastic syndrome
Oncology
Rituximab
Stem cell transplantation
Stem cells
Transplantation
Transplantation, Autologous
Transplantation, Homologous - adverse effects
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Summary:Donor-derived hematological malignancies have been recognized as rare but serious late complications in allogeneic hematopoietic stem cell transplantation (allo-HSCT) recipients. Most cases in the literature were diagnosed as myelodysplastic syndrome or acute leukemia, with very few malignant lymphoma reported. We herein present another case of donor-derived Burkitt lymphoma that occurred 9 years after allo-HSCT under continued administration of immunosuppressants for chronic graft-versus-host disease (GVHD). The patient achieved a partial response after rituximab-combined intensive chemotherapy. To reduce the risk of relapse and to avoid organ toxicities due to repeated chemotherapies, we performed upfront high-dose chemotherapy followed by stem cell rescue using donor-derived CD34 + cells, called pseudo-autologous HSCT (pASCT), and adjusted immunosuppressants appropriately. The patient remained disease-free for 23 months after pASCT without exacerbation of cGVHD. Although the observation period has been relatively short and longer follow-up is needed, pASCT may be a feasible option for donor-derived lymphoma even in patients with active cGVHD.
ISSN:0925-5710
1865-3774
DOI:10.1007/s12185-022-03458-x