Richter's syndrome after allogeneic stem cell transplantation for chronic lymphocytic leukaemia successfully treated by withdrawal of immunosuppression, and donor lymphocyte infusion.

Abstract

Development of high-grade non-Hodgkin's lymphoma is a possible complication of chronic lymphocytic leukaemia/small lymphocytic lymphoma, known as Richter's syndrome (RS). Treatment for RS includes systemic chemotherapy and, recently, allogeneic stem cell transplantation (SCT). We describe a patient with B-chronic lymphocytic leukaemia who developed RS 4 months after allogeneic SCT from an HLA-identical sibling. The RS presented with systemic symptoms, lymphadenopathy, pancytopenia and serum lactate dehydrogenase elevation. The patient was treated with immunosuppressive drug withdrawal and a donor lymphocyte infusion (DLI) of 1 x 10(7) CD3/kg, leading to the disappearance of all symptoms and the attainment of complete donor chimerism. After 18 months of the therapeutic DLI, the patient continues in complete remission.

• Authors: I Español, T Büchler, C Ferrá, D Gallardo, P Reyes, J Sarrá, A Domingo, V Romagosa, A Grañena
• Journal: Bone marrow transplantation (Bone Marrow Transplant) Vol. 31 Issue 3 Pg. 215-8 (Feb 2003) ISSN: 0268-3369 [Print] England
• PMID: 12621484 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Erythrocytes (pathology)
• Female
• Humans
• Immunosuppression Therapy (methods)
• Leukemia, Lymphocytic, Chronic, B-Cell (blood, pathology, therapy)
• Lymphocyte Transfusion
• Lymphoma, Non-Hodgkin (etiology)
• Middle Aged
• Stem Cell Transplantation (adverse effects)
• Time Factors
• Transplantation Chimera
• Transplantation, Homologous (immunology)