Graft-versus-lymphoma effect in a 64-year-old caucasian woman after allogeneic stem-cell transplantation: a case report.

Journal of Medical Case Reports
Gerhard BehreMaximilian Christopeit

Abstract

The existence of a graft-versus-lymphoma effect is well established. When lacking a firm diagnosis, however, the clinician is challenged to to weigh the potential benefits of the graft-versus-lymphoma effect against potential dangers of graft-versus-host disease as well as against generalized (viral) infections. We present evidence for a graft-versus-lymphoma effect in a 64-year-old caucasian woman with a transplanted peripheral blood-stem-cell graft from her Human Leukocyte Antigen-identical sister, and propose diagnostic measures to distinguish between graft-versus-host effect, and against viral disease or drug-induced reactions. We were able to identify an allogeneic graft-reaction against progressive lymphoma alongside an erythema consistent with acute graft-versus-host disease of the skin. Establishing a firm diagnosis enabled us to decide against T-cell suppression (such as by using cyclosporine). Anti-lymphoma activity was favoured, by means of the allogeneic graft, local radiation and immunotherapy. This illustrates the importance of a sound differential diagnosis of erythema after allogeneic stem-cell transplantation, including assessment of viral disease of the affected tissue.

References

Sep 10, 2003·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Michael R Bishop
Aug 12, 2008·European Journal of Haematology·Gerhard Behre, Maximilian Christopeit

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Citations

Dec 10, 2017·Hematology·Melanie Grant, Catherine M Bollard
Jan 4, 2018·Blood Advances·Melanie Grant, Catherine M Bollard
May 15, 2015·The Indian Journal of Surgery·Sedat YahsiCevdet Serkan Gokkaya

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Methods Mentioned

BETA
biopsy
PCR
biopsies

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