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Graft versus lymphoma effect after early relapse following reduced-intensity sibling allogeneic stem cell transplantation for relapsed cytotoxic variant of mycosis fungoides

Bone Marrow Transplantation volume 40, pages 401–403 (2007)Cite this article

A 45-year-old man was diagnosed with a cytotoxic (CD8+ve CD56+ve TIA-1+ve) variant of mycosis fungoides (MF) stage IB, in 2002. He presented with patches and plaques involving the face, trunk and lower limbs. His disease rapidly progressed to tumour stage over the course of the following 4 months, with cutaneous tumours, cervical and axillary lymphadenopathy, pulmonary nodules and gingival ulceration, which upon biopsy proved to be involved with lymphoma. At diagnosis, T-cell receptor rearrangement analysis of the skin lesions demonstrated the presence of a T-cell clone; however, peripheral blood PCR was polyclonal and no Sezary cells were seen. He was treated with CHOP chemotherapy achieving only a transient and partial remission. He then underwent total skin electron beam therapy before progressing to a BEM (BCNU, etoposide and melphalan) conditioned autologous peripheral blood stem cell transplant (SCT). T-cell depletion of the graft was performed in vitro (CD34+ve immunoselection) and in vivo (intravenous Campath 1H). The patient was planned for elective allogeneic SCT within 6 months following his autograft, as previously published evidence from our centre suggests that a majority of patients suffer early relapse.1

On day +64, he developed a lesion on his leg, which preceded a rapid relapse with multiple cutaneous plaques and patches. Biopsy confirmed disease relapse. The neoplastic cells upon relapse were found to have an aberrant phenotype with loss of expression of CD2, CD4 and TIA-1.

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Authors and Affiliations

  1. Department of Clinical Haematology, Hammersmith Hospital, London, UK

    I H Gabriel, E Olavarria, A Chaidos & J F Apperley

  2. Skin Tumour Unit, St Johns Institute of Dermatology, St Thomas' Hospital, London, UK

    R R Jones & S Whittaker

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  1. I H Gabriel
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  2. E Olavarria
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  3. R R Jones
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  4. S Whittaker
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  5. A Chaidos
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  6. J F Apperley
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Correspondence to I H Gabriel.

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Gabriel, I., Olavarria, E., Jones, R. et al. Graft versus lymphoma effect after early relapse following reduced-intensity sibling allogeneic stem cell transplantation for relapsed cytotoxic variant of mycosis fungoides. Bone Marrow Transplant 40, 401–403 (2007). https://doi.org/10.1038/sj.bmt.1705741

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