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Neuro Oncol 2005 7(4):508-510; DOI:10.1215/S1152851705000256
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Duke University Press

Immunology

Combined immunoradiotherapy induces long-term remission of CNS relapse of peripheral, diffuse, large-cell lymphoma after allogeneic stem cell transplantation: Case study

Christian Lotze, Frank Schüler, William H. Krüger1, Carsten Hirt, Michael Kirsch, Silke Vogelgesang, Christian A. Schmidt and Gottfried Dölken

Internal Medicine C (Hematology and Oncology, Transplant Centre) (C.L., F.S., W.H.K., C.H., C.A.S., G.D.), Institute for Radiology (M.K.), and Institute for Pathology (S.V.), Ernst-Moritz-Arndt University, Greifswald, Germany

1 Address correspondence to William Krüger, Medizinische Klinik C (Hämatologie und Onkologie, Transplantationszentrum), Ernst-Moritz-Arndt-Universität Greifswald, Ferdinand-Sauerbruch-Straße, 17487 Greifswald, Germany (e-mail: william.krueger{at}uni-greifswald.de).

Abstract

Relapse of peripheral non-Hodgkin's lymphoma (NHL) in the central nervous system commonly has a poor prognosis. Graft-versus-leukemia effects (GvL) contribute substantially to eradication of hematological malignancies after allogeneic stem cell transplantation. Few data are available describing GvL activity within the brain. We report the case of a man allografted for peripheral NHL. On day +83 after transplantation a CNS relapse of the lymphoma occurred. The brain was irradiated with 44 Gy, anti-CD20 antibodies were given, and the immunosuppression was withdrawn. Subsequently, limited-stage, chronic graft-versus-host disease occurred. The lymphoma regressed completely, and the patient has been in continuous complete remission for 30 months. The favorable course suggests substantial contribution of immunomodulation to excellent outcome.






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