Graft-versus-lymphoma effect in a 64-year-old caucasian woman after allogeneic stem-cell transplantation: a case reportReportar como inadecuado




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Journal of Medical Case Reports

, 3:10

First Online: 13 January 2009Received: 14 April 2008Accepted: 13 January 2009DOI: 10.1186-1752-1947-3-10

Cite this article as: Behre, G., Weber, T., Theurich, S. et al. J Med Case Reports 2009 3: 10. doi:10.1186-1752-1947-3-10

Abstract

IntroductionThe existence of a graft-versus-lymphoma effect is well established. When lacking a firm diagnosis, however, the clinician is challenged to to weigh the potential benefits of the graft-versus-lymphoma effect against potential dangers of graft-versus-host disease as well as against generalized viral infections.

Case presentationWe present evidence for a graft-versus-lymphoma effect in a 64-year-old caucasian woman with a transplanted peripheral blood-stem-cell graft from her Human Leukocyte Antigen-identical sister, and propose diagnostic measures to distinguish between graft-versus-host effect, and against viral disease or drug-induced reactions.

ConclusionWe were able to identify an allogeneic graft-reaction against progressive lymphoma alongside an erythema consistent with acute graft-versus-host disease of the skin. Establishing a firm diagnosis enabled us to decide against T-cell suppression such as by using cyclosporine. Anti-lymphoma activity was favoured, by means of the allogeneic graft, local radiation and immunotherapy. This illustrates the importance of a sound differential diagnosis of erythema after allogeneic stem-cell transplantation, including assessment of viral disease of the affected tissue.

AbbreviationsHLAHuman Leukocyte Antigens

PCRpolymerase chain reaction

EBVEpstein-Barr Virus

CMVCytomegalovirus

LMP1latent membrane protein 1

Electronic supplementary materialThe online version of this article doi:10.1186-1752-1947-3-10 contains supplementary material, which is available to authorized users.

Gerhard Behre and Maximilian Christopeit contributed equally to this work.

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Autor: Gerhard Behre - Thomas Weber - Sebastian Theurich - Maximilian Christopeit

Fuente: https://link.springer.com/







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