Korean J Hematol.  2009 Dec;44(4):284-288. 10.5045/kjh.2009.44.4.284.

A Case of Successful Allogeneic Stem Cell Transplantation for Chemotherapy-refractory Hepatosplenic gamma delta-T Cell Lymphoma

• Kim SB
• Jeong SH
• Park JH
• Kim HS
• Kim BK
• Lee HS

• KMID: 2252111
• DOI: http://doi.org/10.5045/kjh.2009.44.4.284

Abstract

Hepatosplenic T-cell lymphoma is a rare histologic type of peripheral T-cell lymphoma, which is characterized clinically by predominant involvement of the liver and spleen, with little or no adenopathy, and an often aggressive course. We experienced a case of a 44-year-old female who was diagnosed with hepatosplenic gamma delta T-cell lymphoma with bone marrow involvement. The patient was treated with multi- agent chemotherapy with Bortezomib plus CHOP (cyclophosphamide, vincristine, prednisone, doxorubicin), Alemtuzumab plus DHAP (dexamethasone, cisplatin, cytarabine), and IMVP-16 (Ifosfamide, MTX, etoposide); however, she failed to achieve partial remission. After salvage chemotherapy (GemOx: Gembicine, oxaliplatin, dexamethasone), she underwent allogeneic stem cell transplantation from an HLA sibling donor with one mismatch . The patient is currently living and has remained in complete remission for 6 months since transplantation.

Keyword

Hepatosplenic; gamma delta T-cell; Stem cell transplantation

MeSH Terms

Adult
Antibodies, Monoclonal, Humanized
Bone Marrow
Boronic Acids
Cisplatin
Female
Humans
Liver
Lymphoma
Lymphoma, T-Cell
Lymphoma, T-Cell, Peripheral
Organoplatinum Compounds
Prednisone
Pyrazines
Siblings
Spleen
Stem Cell Transplantation
Stem Cells
Tissue Donors
Transplants
Vincristine
Bortezomib
Antibodies, Monoclonal, Humanized
Boronic Acids
Cisplatin
Organoplatinum Compounds
Prednisone
Pyrazines
Vincristine

Figure

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  Fig. 1. Histology and immunohistochemistry analysis of spleen (×400). (A) Atypical lymphoid cell are positively stained for H&E. (B) positvely stained for CD3. (C) negatively stained for CD4. (D) positively stained for TIA-1.

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  Fig. 2. Immunohistochemical study of bone marrow (×400). Atypical lymphoid cell are positively stained for CD3.

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  Fig. 3. Abdominal CT. (A) Before salvage chemotherapy shows hepatomegaly and involving the multiple lymph nodes in the perigastric, porta hepatis, and peripancreatic, and some ascites with peritoneal thickening. (B) Before transplantation after salvage chemotherapy still shows hepatomegaly but slightly decreased size of the lymph nodes (C) 6 months after transplantation, significant interval decrease in the size of liver and the multiple lymph nodes.

Reference

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