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Rapid response to IFN-α in a patient with relapsed follicular lymphoma after cord blood transplantation

Bone Marrow Transplantation volume 46, pages 448–449 (2011)Cite this article

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Allogeneic hematopoietic SCT (HSCT) has emerged as a promising treatment modality for selected patients with relapsed or refractory follicular lymphoma. However, substantial treatment-related mortality after myeloablative conditioning and an increased risk of late disease progression after reduced-intensity conditioning are major concerns.1 Bloor et al.2 reported that 13 of 17 patients with relapsed or refractory follicular lymphoma after HSCT responded to donor lymphocyte infusion (DLI). Their results supported the existence of a clinically significant graft-vs-tumor effect in follicular lymphoma. However, DLI cannot be performed in patients who relapse after umbilical cord blood transplantation (UCBT) with a few exceptions, and no alternative strategies have yet been established. We report a patient with relapsed follicular lymphoma after UCBT who was treated successfully with IFN-alpha (IFN-α) without DLI or re-transplantation.

The patient was a 60-year-old man with an 18-year history of treatment for follicular lymphoma. Although each lymph node was <2 cm in diameter, leukemic changes, non-infectious fever and pancytopenia had been induced by massive BM infiltration of lymphoma cells with reticulin fibrosis. Chemotherapy was ineffective, resulting in the need for frequent blood transfusions. He therefore underwent one-HLA-A-mismatched UCBT with a conditioning regimen consisting of fludarabine, melphalan, and TBI. Cyclosporine and short-term MTX were administered for GVHD prophylaxis. Examination of BM aspirated on day 28 showed complete donor chimerism. There were no symptoms of chronic GVHD, and cyclosporine was stopped on day 172. Several opportunistic infections including HHV-6 reactivation, Aspergillus antigenemia, relapsed chickenpox and Pneumocystis pneumonia developed, but resolved with appropriate antimicrobial therapy.

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Authors and Affiliations

  1. Department of Hematology, Kitano Hospital, Osaka, Japan

    N Arima, N Yoshinaga, W Maruyama, A Fukunaga, H Hirata & T Uchiyama

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  1. N Arima
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  2. N Yoshinaga
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  3. W Maruyama
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  4. A Fukunaga
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  5. H Hirata
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  6. T Uchiyama
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Correspondence to N Arima.

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Arima, N., Yoshinaga, N., Maruyama, W. et al. Rapid response to IFN-α in a patient with relapsed follicular lymphoma after cord blood transplantation. Bone Marrow Transplant 46, 448–449 (2011). https://doi.org/10.1038/bmt.2010.104

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