Fujimaki Katsumichi, Hibino Yuto, Kishimoto Kumiko, Watanabe Shinichiro, Koyama Satoshi, Ando Taiki, Kanamori Heiwa, Nakajima Hideaki
Department of Hematology, Fujisawa City Hospital, Kanagawa, Japan.
Department of Clinical Laboratory Medicine, Fujisawa City Hospital, Kanagawa, Japan.
Blood Cell Ther. 2021 Apr 30;4(2):44-47. doi: 10.31547/bct-2020-018. eCollection 2021 May 25.
The prognosis for relapsed adult T-cell leukemia/lymphoma (ATL) after allogeneic hematopoietic stem cell transplantation is poor. Here, we report the case of a 67-year-old man who survived for 26 months after treatment with lenalidomide for post-transplant relapsed ATL. He underwent induction therapy with two cycles of modified VCAP-AMP-VECP and achieved complete remission. He received cord blood cell transplantation following a reduced-intensity conditioning regimen. Seven months after transplantation, swelling of the systemic lymph nodes appeared, and relapsed ATL was diagnosed based on a biopsy of the cervical lymph node. Treatment with 10 mg of lenalidomide induced partial remission. At 18 months after transplantation, skin tumors were successfully treated by increasing the dose of lenalidomide to 15 mg with the emergence of skin graft-versus-host disease. Although he died from ATL at 34 months after transplantation, systemic relapsed lesions were controlled by treatment with lenalidomide for 26 months. Our case suggests that lenalidomide is well tolerated and is an effective option for the treatment of post-transplant relapsed ATL.
异基因造血干细胞移植后复发的成人T细胞白血病/淋巴瘤（ATL）预后较差。在此，我们报告一例67岁男性患者，他在接受来那度胺治疗移植后复发的ATL后存活了26个月。他接受了两个周期的改良VCAP-AMP-VECP诱导治疗并实现完全缓解。他在接受减低强度预处理方案后接受了脐血细胞移植。移植后7个月，全身淋巴结肿大，经颈部淋巴结活检确诊为复发ATL。使用10 mg来那度胺治疗诱导部分缓解。移植后18个月，随着皮肤移植物抗宿主病的出现，将来那度胺剂量增加至15 mg成功治疗了皮肤肿瘤。尽管他在移植后34个月死于ATL，但来那度胺治疗将全身复发病变控制了26个月。我们的病例表明，来那度胺耐受性良好，是治疗移植后复发ATL的有效选择。
