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Autologous hematopoietic stem cell transplantation for intravascular large B-cell lymphoma: the European Society for Blood and Marrow Transplantation experience

Bone Marrow Transplantation volume 52, pages 650–652 (2017)Cite this article

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Intravascular lymphomas are rare lymphoproliferative disorders characterized by the selective growth of malignant lymphoid cells within the lumina of small vessels. On histological and immunohistochemical examination, around 90% of reported cases meet the criteria of large B-cell lymphoma1 and are categorized into a distinct entity in the WHO classification under the designation intravascular large B-cell lymphoma (IVLBCL).2 Although IVLBCL can involve extranodal sites in virtually any organ, skin and central nervous system are predilection sites in Western countries, whereas Asian patients more often present with involvement of bone marrow, liver and spleen.1, 3, 4 The presence of isolated cutaneous lesions is associated with a better outcome,5 whereas central nervous system IVLBCL has particularly poor survival.1 Treatment recommendations for IVLBCL are largely based on retrospective studies and case reports. The combination of rituximab and cyclophosphamide, doxorubicin, VCR, and prednisone (R-CHOP) is widely used as first-line therapy, but with a PFS at 2 years of only 50–60%6 outcome is inferior to non-intravascular diffuse large B-cell lymphoma.

To improve outcome, more intensive treatment approaches have been pursued in individual patients. Autologous hematopoietic stem cell transplantation (autoHSCT) has been reported to result in a more favorable outcome in single cases7, 8, 9, 10, 11, 12, 13, 14 and small case series, almost exclusively in patients of Asian origin (Supplementary Material). In detail, in the pre-rituximab era, two out of four5 and five out of seven4 autografted patients with IVLBCL were described to survive without relapse. After introduction of rituximab, seven out of seven6 and six out of six15 patients have been reported to remain alive and relapse-free after autoHSCT.

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Acknowledgements

We thank all European Society for Blood and Marrow Transplantation centers that participated in this study.

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Authors and Affiliations

  1. Department of Medicine V, University of Heidelberg, Heidelberg, Germany

    J Meissner, S Dietrich & P Dreger

  2. European Society for Blood and Marrow Transplantation Lymphoma Working Party, Paris, France

    H Finel, S Dietrich, A Boumendil, E Kanfer, G Laboure, M Abecasis, J Cornelissen, J Delage, J Finke, U Hess, H Ludwig, M Mohty, T Pabst, P Pioltelli, S Robinson, P Samaras, S Montoto & P Dreger

  3. Department of Haematology, Hammersmith Hospital, London, UK

    E Kanfer

  4. Service d'Hématologie et thérapie cellulaire, Centre Hospitalier Universitaire des Bordeaux, Bordeaux, France

    G Laboure

  5. Serviço de Hematologia, Instituto Portugues Oncologia, Lisbon, Portugal

    M Abecasis

  6. Department of Hematology, Erasmus MC-Daniel den Hoed Cancer Centre, Rotterdam, The Netherlands

    J Cornelissen

  7. Départment d'Hématologie Clinique, Centre Hospitalier Universitaire Lapeyronie, Montpellier, France

    J Delage

  8. Klinik für Innere Medizin I, University of Freiburg, Freiburg, Germany

    J Finke

  9. Klinik für Onkologie/Hämatologie, Kantonspital, St Gallen, Switzerland

    U Hess

  10. I. Medizinische Abteilung, Wilhelminenspital, Vienna, Austria

    H Ludwig

  11. Départment d'Hématologie clinique et thérapie cellulaire, Hopital Saint Antoine, Paris, France

    M Mohty

  12. Universitätsklinik für Medizinische Onkologie, Ematologia, University Hospital, Bern, Switzerland

    T Pabst

  13. Ematologia, Ospedale San Gerardo, Monza, Italy

    P Pioltelli

  14. Bristol Haematology Unit, Bristol Oncology Centre, Bristol, UK

    S Robinson

  15. Klinik für Onkologie, University Hospital, Zürich, Switzerland

    P Samaras

  16. Centre for Medical Oncology, St Bartholomew’s Hospital, London, UK

    S Montoto

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  1. J Meissner
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  19. P Dreger
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Corresponding author

Correspondence to J Meissner.

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The authors declare no conflict of interest.

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Supplementary Information accompanies this paper on Bone Marrow Transplantation website

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Meissner, J., Finel, H., Dietrich, S. et al. Autologous hematopoietic stem cell transplantation for intravascular large B-cell lymphoma: the European Society for Blood and Marrow Transplantation experience. Bone Marrow Transplant 52, 650–652 (2017). https://doi.org/10.1038/bmt.2016.339

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