mesna and Lymphoma--T-Cell--Peripheral

We report a novel regimen for refractory post-transplant T-cell lymphoma (PTL). Our patient presented with non-Epstein-Barr virus (EBV) related, T-cell post-transplant lymphoproliferative disease (PTLD) 3.5 years after liver transplantation. Initially diagnosed as polyclonal PTLD, the disease progressed to a monoclonal, T-cell PTL that was refractory to several chemotherapy regimens but responded to a regimen consisting of fludarabine, cyclophosphamide, cytarabine, and alemtuzumab. Consolidation therapy included high-dose chemotherapy, autologous hematopoietic stem cell rescue, and radiation therapy. She remains in remission 2.5 years later. T-cell PTL is a rare disease with a poor prognosis; this regimen provides a novel, potentially curative approach for its treatment.

Topics: Alemtuzumab; Antibodies, Monoclonal; Antibodies, Monoclonal, Humanized; Antibodies, Neoplasm; Antineoplastic Combined Chemotherapy Protocols; Biliary Atresia; Carboplatin; Carmustine; Cyclophosphamide; Cytarabine; Disease Progression; Doxorubicin; Etoposide; Female; Granulocyte Colony-Stimulating Factor; Hematopoietic Stem Cell Transplantation; Humans; Ifosfamide; Immunocompromised Host; Immunosuppressive Agents; Liver Transplantation; Lymphoma, T-Cell, Peripheral; Lymphoproliferative Disorders; Melphalan; Mesna; Postoperative Complications; Prednisone; Radiotherapy, Adjuvant; Transplantation, Autologous; Vidarabine; Vincristine