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

Neuro-Oncology

Antibodies, Adult, therapeutic use, Antigens, CD20, immunology, Brain Neoplasms, pathology, radiotherapy, Graft vs Leukemia Effect, physiology, Humans, Lymphoma, Large B-Cell, Diffuse, Male, Neoplasm Recurrence, Local, Stem Cell Transplantation

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      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 The brain was irradiated with 44 Gy, anti-CD20 antibodies were given, and the immunosuppression was withdrawn.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.

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      Journal
      16212815
      1871735
      10.1215/S1152851705000256

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