Non-myeloablative Hematopoietic Stem Cell Transplantation for the Treatment of Adult T-cell Lymphoma in a Patient with Advanced Hepatic Impairment

• Published in: Leukemia & lymphoma Vol. 44; no. 4; pp. 703 - 708
• Main Authors: Hamaki, Tamae, Kami, Masahiro, Igarashi, Masahiro, Kusumi, Eiji, Arase, Yasuji, Ishibashi, Toru, Shimamura, Kenji, Miyakoshi, Shigesaburo, Morinaga, Shin-ichi, Takaue, Yoichi, Hayashi, Masahiro, Mutou, Yoshitomo
• Format: Journal Article
• Language: English
• Published: United States Informa UK Ltd 01.01.2003; Taylor & Francis
• Subjects: Adult T-cell Lymphoma; Advanced Hepatic Failure; Antineoplastic Agents - pharmacokinetics; Antineoplastic Agents, Alkylating - pharmacokinetics; Cyclophosphamide - pharmacokinetics; Hematopoietic Stem Cell Transplantation - methods; Hepatitis B - complications; Hepatitis B virus; Humans; Liver Cirrhosis - pathology; Lymphoma, T-Cell - mortality; Lymphoma, T-Cell - therapy; Male; Middle Aged; Non-myeloablative Transplant; Stem Cell Transplant; T-ALL; Time Factors; Vidarabine - analogs & derivatives; Vidarabine - pharmacokinetics
• ISSN: 1042-8194; 1029-2403
• DOI: 10.1080/1042819031000097096

A 59-year-old man with liver cirrhosis due to hepatitis B virus infection received non-myeloablative stem-cell transplantation (NST) for the treatment of adult T-cell lymphoma. The preparative regimen consisted of cyclophosphamide and fludarabine. While the pharmacokinetics of these drugs was altered in this patient, his clinical course was uneventful without the development of severe hepatic damage. Complete remission was achieved on day 56. Although he finally died of hemorrhage from esophageal varices on day 68, this case suggests that ATL may be a good candidate for allogeneic HSCT, and that NST may be feasible for patients with hepatic impairment.