Primary distal femur T-cell lymphoma after allogeneic haematopoietic stem cell transplantation for chronic myeloid leukaemia: A rare case report and literature review

• Published in: Journal of international medical research Vol. 42; no. 2; pp. 598 - 605
• Main Authors: Han, Qiaoyan, Sun, Miao, Wu, Lingyu, Chen, Jing, Wang, Wei, Liu, Chunhua, Chen, Haoyue, Du, Guibin
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.04.2014; Sage Publications
• Subjects: Adult; Angiogenesis Inhibitors - therapeutic use; Antimetabolites, Antineoplastic - therapeutic use; Antineoplastic Agents - therapeutic use; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biological and medical sciences; Cisplatin - therapeutic use; Cytarabine - therapeutic use; Dexamethasone - therapeutic use; Harringtonines - therapeutic use; Hematologic and hematopoietic diseases; Hematopoietic Stem Cell Transplantation; Humans; Hydroxyurea - therapeutic use; Leukemia, Myelogenous, Chronic, BCR-ABL Positive - drug therapy; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Lymphoma, T-Cell - drug therapy; Lymphoma, T-Cell - mortality; Lymphoma, T-Cell - radiotherapy; Male; Medical sciences; Neoplasm Invasiveness - pathology; Pharmacology. Drug treatments; Transplantation, Homologous; post-transplant lymphoproliferative disorder; Haematopoietic stem cell transplantation; T-cell lymphoma; chronic myeloid leukaemia; Human; Stem cell; Chronic myelogenous leukemia; Malignant hemopathy; Non Hodgkin lymphoma; Allogeneic system; Case study; Myeloproliferative syndrome; Posttransplant lymphoproliferative disorder; Distal; Lymphoproliferative syndrome; T-Lymphocyte; Bibliographic review; Cancer
• ISSN: 0300-0605; 1473-2300
• DOI: 10.1177/0300060513507646

Post-transplant lymphoproliferative disorders originating from T lymphocytes are a rare complication of allogeneic haematopoietic stem cell transplantation (allo-HSCT) that are not usually associated with Epstein–Barr virus infection. A male patient diagnosed at the age of 15 years with chronic myeloid leukaemia (in the chronic phase) was initially treated with oral hydroxyurea. The disease entered an accelerated phase when the patient was 22 years old. Complete remission was achieved after one course of homoharringtonine and cytarabine. The patient then underwent human leucocyte antigen-matched sibling donor allo-HSCT. Just over 6.5 years after the allo-HSCT, a second primary tumour was located in the distal femur and diagnosed as T-cell non-Hodgkin’s lymphoma (stage IV, group B). This was treated with various chemotherapy and radiotherapy regimens, but the outcomes were poor and the disease progressed. The T-cell lymphoma invaded many sites, including the skeleton, spleen and skin, and the patient died within 8 months of the diagnosis. This current case report highlights the need for the early detection and prevention of subsequent primary malignancies after allo-HSCT.