Antileukaemic rescue by dose-dense donor-lymphocyte infusions in T-PLL after allogeneic stem cell transplantation - a case report

Ann Hematol. 2024 Nov;103(11):4777-4778. doi: 10.1007/s00277-024-05929-z. Epub 2024 Sep 6.

Abstract

T-Cell Prolymphocytic Leukaemia (T-PLL) is an aggressive disease with a poor prognosis and only curable by allogeneic stem cell transplantation. We describe the case of a male suffering from T-PLL. Therapy was alemtuzumab followed by an allograft from an unrelated donor. T-PLL relapsed after allogeneic stem cell transplantation. Discontinuation of immunosuppression had no effected and three increasing doses of donor lymphocytes were given within one month. The patient developed acute GvHD of the lover (grade III). GvHD was successfully treated by steroids and ruxolitinib and graft-versus-leukaemia effects induced a complete remission of T-PLL. 18,5 months after transplantation the patient is well and alive without GvHD under immunosuppression with ruxolitinib. Flow cytometry of peripheral blood was negative for residual leukemic cells.

Keywords: Allogeneic stem cell transplantation; Donor-lymphocyte infusions; GvL-effects; T-Cell prolymphocytic leukaemia.

Publication types

  • Case Reports

MeSH terms

  • Alemtuzumab / administration & dosage
  • Alemtuzumab / therapeutic use
  • Allografts
  • Graft vs Host Disease / etiology
  • Graft vs Leukemia Effect
  • Hematopoietic Stem Cell Transplantation*
  • Humans
  • Leukemia, Prolymphocytic, T-Cell* / therapy
  • Lymphocyte Transfusion*
  • Male
  • Middle Aged
  • Nitriles / therapeutic use
  • Pyrazoles / administration & dosage
  • Pyrazoles / therapeutic use
  • Pyrimidines / administration & dosage
  • Pyrimidines / therapeutic use
  • Transplantation, Homologous

Substances

  • Alemtuzumab
  • Nitriles
  • ruxolitinib
  • Pyrimidines
  • Pyrazoles