Successful treatment with reduced-intensity stem cell transplantation in a case of relapsed refractory central nervous system lymphoma

Aoyama, Yasutaka; Yamamura, Ryosuke; Shima, Etsuko; Nakamae, Hirohisa; Makita, Kaori; Kho, Genzyu; Ohta, Kensuke; Yamane, Takahisa; Takubo, Takayuki; Hino, Masayuki

doi:10.1007/s00277-003-0651-z

Cited by 15 publications

(8 citation statements)

References 10 publications

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“…Using non-myeloablative conditioning regimens to provide potent immune suppression without toxicity, the burden of cure then relies on the ability of transplanted donor cells to provide a GvT effect. Precedence in using low-intensity conditioning before transplanting allogeneic stem cells has been reported in Ewing sarcoma ( 269 – 271 ), osteosarcoma ( 272 , 273 ), germ cell tumors ( 274 ), rhabdomyosarcoma ( 275 – 277 ), neuroblastoma ( 278 – 280 ), Wilms tumor ( 281 ), and CNS tumors ( 282 ), suggesting that alloreactive donor NK cells infiltrate heterogeneous solid tumors and cross the blood–brain barrier. A sizeable reduction in tumor burden has been observed ( 269 ).…”

Section: Nk Cells In Health and Diseasementioning

confidence: 99%

Natural Killer Cells: Development, Maturation, and Clinical Utilization

et al. 2018

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Natural killer (NK) cells are the predominant innate lymphocyte subsets that mediate anti-tumor and anti-viral responses, and therefore possess promising clinical utilization. NK cells do not express polymorphic clonotypic receptors and utilize inhibitory receptors (killer immunoglobulin-like receptor and Ly49) to develop, mature, and recognize “self” from “non-self.” The essential roles of common gamma cytokines such as interleukin (IL)-2, IL-7, and IL-15 in the commitment and development of NK cells are well established. However, the critical functions of pro-inflammatory cytokines IL-12, IL-18, IL-27, and IL-35 in the transcriptional-priming of NK cells are only starting to emerge. Recent studies have highlighted multiple shared characteristics between NK cells the adaptive immune lymphocytes. NK cells utilize unique signaling pathways that offer exclusive ways to genetically manipulate to improve their effector functions. Here, we summarize the recent advances made in the understanding of how NK cells develop, mature, and their potential translational use in the clinic.

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Section: Nk Cells In Health and Diseasementioning

confidence: 99%

Natural Killer Cells: Development, Maturation, and Clinical Utilization

et al. 2018

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“…Thus, at the time, hematopoiesis of the patients had been fully reconstituted by the respective donor cells, yet the leukemic cells persisted in the CNS. The effectiveness of GvL on extramedullary lesions, especially those in the CNS, is a matter of some controversy [6][7][8]. The present cases may imply that the GvL effects may not be as effective in the CNS as in the BM, although a larger case series needs to be examined to clarify this issue.…”

Section: Discussionmentioning

confidence: 93%

Leukemic relapse in the central nervous system after allogeneic stem cell transplantation with complete remission in the bone marrow and donor‐type chimerism: Report of two cases

et al. 2005

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We studied two cases with leukemia that relapsed in the central nervous system (CNS) after allogeneic stem cell transplantation. One patient underwent peripheral blood stem cell transplantation (SCT) from a related, yet haplotype-mismatched, donor for chronic myelomonocytic leukemia. She was kept in complete remission (CR) in the bone marrow (BM) for 7 months, until relapse in the cerebrospinal fluid (CSF) was evident. In the other patient, with acute lymphoblastic leukemia, systemic relapse occurred when he was still on immunosuppression 6 months after SCT from an unrelated donor. After induction chemotherapy following cessation of immunosuppression, the BM examination proved CR. During consolidation chemotherapy, however, he developed leukemic dissemination in the CSF, despite the fact that the BM was in CR. Chimerism status in the BM mononuclear cells and fractionated peripheral blood (PB) cells (granulocytes, T-lymphocytes, and the others) was assessed by short tandem repeat analysis. In both patients, the BM cells and all the fractions of the PB cells proved donor-type chimeras. These results seem to suggest that the graft-versus-leukemia effects might not be as effective in the CNS as in the BM, even when complete T-lymphoid chimerism is achieved. Am.

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“…Generally, the GVL effect is considered to be more potent against indolent lymphoma compared with aggressive lymphoma as demonstrated by more favorable outcome following reduced-intensity HSCT in the former [16,17]. Although several reports demonstrated the potential role of the GVL effect against aggressive lymphoma, the majority were about B cell lymphoma [18][19][20][21], and the GVL effect against ENKL has not been discussed fully. There has been only one case report supporting the GVL effect against ENKL, in which gradual regression of residual ENKL was observed following the combination of allogeneic HSCT and subsequent DLI [12].…”

Section: Discussionmentioning

confidence: 99%

Regression of the tumor after withdrawal of cyclosporine in relapsed extranodal natural killer/T cell lymphoma following allogeneic hematopoietic stem cell transplantation

et al. 2007

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The prognosis of patients with advanced-stage extranodal natural killer/T cell lymphoma, nasal type (ENKL) has been generally poor, and several anecdotal reports have suggested the role of allogeneic hematopoietic stem cell transplantation (HSCT). A potential advantage of allogeneic HSCT may be the graft-versuslymphoma (GVL) effect. The susceptibility to the GVL effect, however, has been shown to vary according to histologic subtypes, and it has been hardly documented yet whether ENKL is susceptible to the GVL effect. Here we report a patient with advanced-stage ENKL who underwent allogeneic HSCT from an HLA oneallele mismatched related donor, whose clinical course after HSCT suggested the potent GVL effect against ENKL. A 43-year-old female underwent allogeneic HSCT for advanced-stage, chemorefractory ENKL, and achieved complete response. In 4 months after the transplantation, however, the ENKL relapsed in multiple sites. These lesions markedly responded to the discontinuation of immunosuppressive agents and disappeared. Except for a temporal exacerbation of bronchiolitis obliterans organizing pneumonia, she has been free from disease for more than a year without other treatments against lymphoma. The clinical course of the current patient suggests the potent GVL effect against ENKL. Allogeneic HSCT, including that with reduced-intensity regimens, is a promising treatment option for high-risk ENKL. Am. J. Hematol. 82:937-939, 2007. V

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Successful treatment with reduced-intensity stem cell transplantation in a case of relapsed refractory central nervous system lymphoma

Cited by 15 publications

References 10 publications

Natural Killer Cells: Development, Maturation, and Clinical Utilization

Natural Killer Cells: Development, Maturation, and Clinical Utilization

Leukemic relapse in the central nervous system after allogeneic stem cell transplantation with complete remission in the bone marrow and donor‐type chimerism: Report of two cases

Regression of the tumor after withdrawal of cyclosporine in relapsed extranodal natural killer/T cell lymphoma following allogeneic hematopoietic stem cell transplantation

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