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Neuro-Oncology 2005 7(4):508-510; doi:10.1215/S1152851705000256
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© 2005 by the Society for Neuro-Oncology

Combined immunoradiotherapy induces long-term remission of CNS relapse of peripheral, diffuse, large-cell lymphoma after allogeneic stem cell transplantation: Case study

Christian Lotze, Frank Schüler, William H. Krüger1, Carsten Hirt, Michael Kirsch, Silke Vogelgesang, Christian A. Schmidt and Gottfried Dölken

Internal Medicine C (Hematology and Oncology, Transplant Centre) (C.L., F.S., W.H.K., C.H., C.A.S., G.D.), Institute for Radiology (M.K.), and Institute for Pathology (S.V.), Ernst-Moritz-Arndt University, Greifswald, Germany

1 Address correspondence to William Krüger, Medizinische Klinik C (Hämatologie und Onkologie, Transplantationszentrum), Ernst-Moritz-Arndt-Universität Greifswald, Ferdinand-Sauerbruch-Straße, 17487 Greifswald, Germany (e-mail: william.krueger{at}uni-greifswald.de).


  Abstract

Relapse of peripheral non-Hodgkin's lymphoma (NHL) in the central nervous system commonly has a poor prognosis. Graft-versus-leukemia effects (GvL) contribute substantially to eradication of hematological malignancies after allogeneic stem cell transplantation. Few data are available describing GvL activity within the brain. We report the case of a man allografted for peripheral NHL. On day +83 after transplantation a CNS relapse of the lymphoma occurred. The brain was irradiated with 44 Gy, anti-CD20 antibodies were given, and the immunosuppression was withdrawn. Subsequently, limited-stage, chronic graft-versus-host disease occurred. The lymphoma regressed completely, and the patient has been in continuous complete remission for 30 months. The favorable course suggests substantial contribution of immunomodulation to excellent outcome.

Received March 7, 2005; Accepted June 9, 2005


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