Division of Gastroenterology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan.
Department of Hematology and Rheumatology, Tohoku University Hospital, Sendai, Japan.
Clin J Gastroenterol. 2021 Aug;14(4):1108-1114. doi: 10.1007/s12328-021-01389-4. Epub 2021 Mar 30.
A 31-year-old man with Crohn's disease in remission after 6-year treatment with infliximab developed nasopharyngeal diffuse large B cell lymphoma. Infliximab was discontinued, and complete remission was achieved following chemotherapy with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone. However, the patient subsequently experienced severely symptomatic Crohn's disease relapse. Therapy with adalimumab was initiated, and the patient attained remission. However, after 3 months, he suffered a recurrence of the lymphoma. Adalimumab was discontinued, and the patient received further chemotherapy (with rituximab, etoposide, cisplatin, methylprednisolone, and high-dose cytarabine) treatment and underwent allogeneic hematopoietic stem cell transplantation. Following the procedure, Crohn's disease and lymphoma have remained in complete remission for 5 years. There are limited reports on Crohn's disease remission after allogeneic hematopoietic stem cell transplantation. Therefore, we present this case report and a review of the existing literature on allogeneic stem cell transplantation for Crohn's disease.
一名 31 岁男性,患有克罗恩病,经过 6 年英夫利昔单抗治疗后处于缓解期,后发展为鼻咽弥漫性大 B 细胞淋巴瘤。停用英夫利昔单抗后,经利妥昔单抗、环磷酰胺、多柔比星、长春新碱和泼尼松化疗后达到完全缓解。然而,此后该患者出现严重症状性克罗恩病复发。开始使用阿达木单抗治疗,患者获得缓解。然而,3 个月后,他又复发了淋巴瘤。停用阿达木单抗后,患者接受了进一步的化疗(利妥昔单抗、依托泊苷、顺铂、甲泼尼龙和高剂量阿糖胞苷)治疗,并进行了异基因造血干细胞移植。手术后,克罗恩病和淋巴瘤均完全缓解 5 年。关于异基因造血干细胞移植后克罗恩病缓解的报道有限。因此,我们报告了这例病例,并对异基因干细胞移植治疗克罗恩病的现有文献进行了回顾。