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Related Experiment Videos

[CD30-negative diffuse large B-cell lymphoma expressing ALK].

Kazuyoshi Ishii1, Yoshihisa Yamamoto, Shosaku Nomura

  • 1Department of Hematology, Kishiwada City Hospital.

[Rinsho Ketsueki] the Japanese Journal of Clinical Hematology
|January 31, 2006
PubMed
Summary
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A patient with refractory anaplastic large cell lymphoma achieved complete remission after allogeneic stem cell transplant. The graft-versus-lymphoma effect likely contributed to sustained remission, despite a fatal outcome from thrombotic microangiopathy.

Area of Science:

  • Hematology
  • Oncology
  • Immunology

Background:

  • A 33-year-old man presented with undifferentiated carcinoma and lymphadenopathy, later diagnosed as anaplastic large cell lymphoma.
  • The patient experienced relapse twice despite chemotherapy (CHOP) and achieved complete remission (CR) after initial treatment.

Observation:

  • The patient underwent allogeneic peripheral blood stem cell transplantation (PBSCT) from an HLA-matched sibling while in non-CR.
  • Engraftment and complete chimerism were achieved, followed by acute and chronic graft-versus-host disease (GVHD), which were managed with immunosuppression.
  • The patient achieved CR post-PBSCT and maintained complete chimerism.

Findings:

  • Tumor cells were ALK-positive, CD30-negative, with JH rearrangement, classified as diffuse large B-cell lymphoma with ALK expression.

Related Experiment Videos

  • Despite chemotherapy resistance and a complex karyotype, PBSCT led to sustained CR.
  • The patient died seven months post-PBSCT due to fulminant thrombotic microangiopathy.

    • Implications:

    • Allogeneic PBSCT can induce sustained remission in refractory lymphomas, potentially through a graft-versus-lymphoma effect.
    • This case highlights the complex interplay between GVHD, immunosuppression, and anti-tumor responses post-transplant.
    • Further research into optimizing stem cell transplantation strategies for refractory lymphomas is warranted.