Successful treatment of non-Hodgkin's lymphoma using R-CHOP in a patient with Wiskott-Aldrich syndrome followed by a reduced-intensity stem cell transplant.

Abstract

WAS is an X-linked primary immunodeficiency characterized by microthrombocytopenia, eczema, recurrent infections, and increased incidence of autoimmunity and malignancy. HSCT is the only curative treatment for WAS. Herein, we report the case of a 17-yr-old boy with WAS who received an unrelated HSCT while in complete remission of diffuse large B-cell lymphoma after chemotherapy. Pretransplant conditioning consisted of fludarabine, busulfan, and total body irradiation (4 Gy). GvHD prophylaxis consisted of tacrolimus and short-course methotrexate. Following HSCT, rapid and stable engraftment was observed. Platelet count gradually increased, and the generalized eczema improved. The patient developed grade II acute GvHD and limited chronic GvHD on days 30 and 210, respectively, which resolved with immunosuppressive treatment. Symptoms caused by the reactivation of human herpes virus-6, BK virus, and VZV were observed from days 21, 60, and 96, respectively; they were resolved after conservative treatment and acyclovir administration. No other regimen-related toxicity was observed. Complete donor bone marrow chimerism was achieved one month after transplantation. RIST is an effective therapeutic option for older children with WAS accompanied by malignant lymphoma.

• Authors: Yuhki Koga, Hidetoshi Takada, Aiko Suminoe, Shouichi Ohga, Toshiro Hara
• Journal: Pediatric transplantation (Pediatr Transplant) Vol. 18 Issue 6 Pg. E208-11 (Sep 2014) ISSN: 1399-3046 [Electronic] Denmark
• PMID: 24930759 (Publication Type: Case Reports, Journal Article)
• Copyright: © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Chemical References

• Antibodies, Monoclonal, Murine-Derived
• Immunosuppressive Agents
• R-CHOP protocol
• Rituximab
• Vincristine
• Doxorubicin
• Cyclophosphamide
• Prednisone

Topics

• Adolescent
• Antibodies, Monoclonal, Murine-Derived (therapeutic use)
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Combined Modality Therapy
• Cyclophosphamide (therapeutic use)
• Doxorubicin (therapeutic use)
• Graft vs Host Disease (drug therapy)
• Humans
• Immunosuppressive Agents (therapeutic use)
• Lymphoma, Non-Hodgkin (therapy)
• Male
• Prednisone (therapeutic use)
• Rituximab
• Stem Cell Transplantation
• Vincristine (therapeutic use)
• Wiskott-Aldrich Syndrome (complications, therapy)