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Post‐transplant hepatosplenic T‐cell lymphoma successfully treated with hyperCVAD regimen
Author(s) -
Tey SiokKeen,
Marlton Paula V.,
Hawley Carmel M.,
Norris Debra,
Gill Devinder S.
Publication year - 2008
Publication title -
american journal of hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.456
H-Index - 105
eISSN - 1096-8652
pISSN - 0361-8609
DOI - 10.1002/ajh.21062
Subject(s) - medicine , vincristine , immunosuppression , cyclophosphamide , chemotherapy , methotrexate , surgery , transplantation , lymphoma
Hepatosplenic T‐cell lymphoma (HSTL) is an aggressive lymphoma. In post‐transplant immunosuppressed patients, HSTL is usually rapidly fatal. We report successful treatment of post‐transplant HSTL in a 50‐year‐old renal allograft recipient by reducing immunosuppression and using intensive chemotherapy consisting of alternating cycles of HyperCVAD (cyclophosphamide, vincristine, doxorubicin, and dexamethasone) and MTX/HiDAC (methotrexate, Ara‐C). Remission is ongoing at 8+ years. Literature review identified another 20 cases of HSTL in solid organ transplant recipients: median survival was 4 months; no other patients survived beyond 12 months. Bone marrow involvement was universal, but changes were often subtle: 6 of 12 cases had nondiagnostic examinations earlier on. High index of suspicion may lead to more timely diagnosis of this uncommon form of post‐transplant lymphoproliferative disorder, and treatment with intensive chemotherapy such as HyperCVAD may be curative. Am. J. Hematol., 2008. © 2007 Wiley‐Liss, Inc.