Patterns of Late Relapse after Allogeneic Hematopoietic Stem Cell Transplantation in Patients with T-Cell Prolymphocytic Leukemia.

Abstract

Initial treatment with the monoclonal anti-CD52 antibody alemtuzumab induces responses in the majority of patients with T-cell prolymphocytic leukemia (T-PLL). In eligible patients, allogeneic hematopoietic stem cell transplantation (allo-HSCT) is an option to consolidate hematological remissions. Here, we report our experience with 10 patients who received allo-HSCT against T-PLL. Notably, 3 patients with complete remission at transplantation and durable full-donor chimerism relapsed at months 12, 59, and 84 after transplantation, respectively. This relapse was associated with rapid progressive leukemia in 1 patient and extralymphatic lymphoma growth in the other 2. Despite CD52 positivity at relapse, alemtuzumab retreatment, donor lymphocyte infusions, and/or chemotherapy including salvage therapy, allo-HSCT yielded a transient partial response, only. Alemtuzumab induction and consolidative allo-HSCT enabled prolonged disease-free survival in these patients but failed to procure cure.

• Authors: Evgenii Shumilov, Justin Hasenkamp, Christoph Johannes Szuszies, Raphael Koch, Gerald Georg Wulf
• Journal: Acta haematologica (Acta Haematol) Vol. 144 Issue 1 Pg. 105-110 ( 2021) ISSN: 1421-9662 [Electronic] Switzerland
• PMID: 32259827 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2020 S. Karger AG, Basel.

Topics

• Combined Modality Therapy
• Female
• Graft vs Host Disease (diagnosis, etiology)
• Hematopoietic Stem Cell Transplantation (adverse effects, methods)
• Humans
• Immunophenotyping
• Leukemia, Prolymphocytic, T-Cell (diagnosis, mortality, therapy)
• Male
• Prognosis
• Recurrence
• Transplantation Chimera
• Transplantation Conditioning
• Transplantation, Homologous
• Treatment Outcome