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Allogeneic stem cell transplantation after reduced-intensity conditioning in a patient with T-cell prolymphocytic leukemia: graft-versus-tumor effect and long-term remission

Bone Marrow Transplantation volume 37, pages 709–710 (2006)Cite this article

T-cell prolymphocytic leukemia (T-PLL) is a rare aggressive lymphoid malignancy associated with a short median patient survival and poor response to chemotherapy.1, 2, 3 Currently, there is no standard treatment for T-PLL, and disease progression ultimately occurs in most cases. Allogeneic stem cell transplantation (allo-SCT) with myeloablative conditioning has been used in a few cases with T-PLL.2, 4, 5, 6 However, treatment-related mortality is significant with this kind of conditioning, precluding its use in elderly or heavily pre-treated patients. However, reduced-intensity conditioning (RIC) allo-SCT has been shown to be associated with decreased transplant-related toxicities while preserving the graft-versus-tumor effect (GVT).7 We report the case of a T-PLL patient successfully treated with RIC allo-SCT.

In January 2002, a 30-year-old male with a previous history of type 1 diabetes, presented with fever, poor general condition and abdominal pain. Physical examination revealed liver enlargement, without peripheral adenopathy. The white blood-cell count was 57 × 109/l with 73% abnormal lymphocytes. Platelets were low at 48 × 109/l. Bone marrow aspirate showed 52% abnormal T-lymphocytes compatible with a diagnosis of T-PLL. Flow cytometric analysis of bone marrow lymphocytes revealed a characteristic post-thymic T-cell phenotype (CD2+, CD5+, CD7+, CD8+, HLA DR+, CD25−). CT-scan showed homogenous liver enlargement and signs of lung infection. Cytogenetic analysis of the abnormal T lymphocytes was normal.

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Authors and Affiliations

  1. Unité de Transplantation et de Thérapie Cellulaire, Institut Paoli-Calmettes, Marseille, France

    H de Lavallade, C Faucher, S Fürst, J El-Cheikh, D Blaise & M Mohty

  2. Département d'Hématologie, Institut Paoli-Calmettes, Marseille, France

    N Vey, D Coso, R Bouabdallah, A-M Stoppa & J-A Gastaut

  3. Université de la Méditerranée, Marseille, France

    J-A Gastaut, D Blaise & M Mohty

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  1. H de Lavallade
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  2. C Faucher
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  4. J El-Cheikh
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  5. N Vey
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  7. R Bouabdallah
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  9. J-A Gastaut
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  10. D Blaise
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  11. M Mohty
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de Lavallade, H., Faucher, C., Fürst, S. et al. Allogeneic stem cell transplantation after reduced-intensity conditioning in a patient with T-cell prolymphocytic leukemia: graft-versus-tumor effect and long-term remission. Bone Marrow Transplant 37, 709–710 (2006). https://doi.org/10.1038/sj.bmt.1705294

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  • DOI: https://doi.org/10.1038/sj.bmt.1705294

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