Persistent Mixed Donor Chimerism following Double Umbilical Cord Transplantation in a Patient with T-Cell Prolymphocytic Leukemia
T-cell prolymphocytic leukemia (T-PLL) is a rare and aggressive postthymic T-cell neoplasm with an associated survival time of 1 year when left untreated. Current standard of care for T-PLL is with alemtuzumab, followed by allogeneic or autologous stem cell transplant. Little is found in the literat...
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| Format: | Article |
| Language: | English |
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Wiley
2019-01-01
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| Series: | Case Reports in Hematology |
| Online Access: | http://dx.doi.org/10.1155/2019/8437805 |
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| author | Ronak H. Mistry Elizabeth O. Hexner James K. Mangan |
| author_facet | Ronak H. Mistry Elizabeth O. Hexner James K. Mangan |
| author_sort | Ronak H. Mistry |
| collection | DOAJ |
| description | T-cell prolymphocytic leukemia (T-PLL) is a rare and aggressive postthymic T-cell neoplasm with an associated survival time of 1 year when left untreated. Current standard of care for T-PLL is with alemtuzumab, followed by allogeneic or autologous stem cell transplant. Little is found in the literature about alternative donor transplantation in T-PLL. Here, we present the case of a patient treated with double umbilical cord blood transplantation, which resulted in initial complete remission. An unusual outcome of this case is that coengraftment of both cords was established. After 16 months, the patient had relapse of the disease, unfortunately, prompting treatment with alemtuzumab and pentostatin, which resulted in remission once again. Here, we report a unique phenomenon whereby single-cord dominance occurred after treatment with these agents, suggesting that anti-T-cell therapy after transplant may help achieve single-unit dominance. A second relapse of the disease occurred six months thereafter, ultimately resulting in the patient’s death, highlighting the aggressive nature of this disease. |
| format | Article |
| id | doaj-art-f44fda4fea754706baef9ff8756c496f |
| institution | Kabale University |
| issn | 2090-6560 2090-6579 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Hematology |
| spelling | doaj-art-f44fda4fea754706baef9ff8756c496f2025-02-03T05:51:55ZengWileyCase Reports in Hematology2090-65602090-65792019-01-01201910.1155/2019/84378058437805Persistent Mixed Donor Chimerism following Double Umbilical Cord Transplantation in a Patient with T-Cell Prolymphocytic LeukemiaRonak H. Mistry0Elizabeth O. Hexner1James K. Mangan2Department of Internal Medicine, Pennsylvania Hospital of the University of Pennsylvania, 800 Spruce Street, Philadelphia, PA 19107, USAAbramson Cancer Center, Perelman Center for Advanced Medicine, University of Pennsylvania, 34th Street and Civic Center Boulevard, 12th Floor South Pavilion, Philadelphia, PA 19104, USAAbramson Cancer Center, Perelman Center for Advanced Medicine, University of Pennsylvania, 34th Street and Civic Center Boulevard, 12th Floor South Pavilion, Philadelphia, PA 19104, USAT-cell prolymphocytic leukemia (T-PLL) is a rare and aggressive postthymic T-cell neoplasm with an associated survival time of 1 year when left untreated. Current standard of care for T-PLL is with alemtuzumab, followed by allogeneic or autologous stem cell transplant. Little is found in the literature about alternative donor transplantation in T-PLL. Here, we present the case of a patient treated with double umbilical cord blood transplantation, which resulted in initial complete remission. An unusual outcome of this case is that coengraftment of both cords was established. After 16 months, the patient had relapse of the disease, unfortunately, prompting treatment with alemtuzumab and pentostatin, which resulted in remission once again. Here, we report a unique phenomenon whereby single-cord dominance occurred after treatment with these agents, suggesting that anti-T-cell therapy after transplant may help achieve single-unit dominance. A second relapse of the disease occurred six months thereafter, ultimately resulting in the patient’s death, highlighting the aggressive nature of this disease.http://dx.doi.org/10.1155/2019/8437805 |
| spellingShingle | Ronak H. Mistry Elizabeth O. Hexner James K. Mangan Persistent Mixed Donor Chimerism following Double Umbilical Cord Transplantation in a Patient with T-Cell Prolymphocytic Leukemia Case Reports in Hematology |
| title | Persistent Mixed Donor Chimerism following Double Umbilical Cord Transplantation in a Patient with T-Cell Prolymphocytic Leukemia |
| title_full | Persistent Mixed Donor Chimerism following Double Umbilical Cord Transplantation in a Patient with T-Cell Prolymphocytic Leukemia |
| title_fullStr | Persistent Mixed Donor Chimerism following Double Umbilical Cord Transplantation in a Patient with T-Cell Prolymphocytic Leukemia |
| title_full_unstemmed | Persistent Mixed Donor Chimerism following Double Umbilical Cord Transplantation in a Patient with T-Cell Prolymphocytic Leukemia |
| title_short | Persistent Mixed Donor Chimerism following Double Umbilical Cord Transplantation in a Patient with T-Cell Prolymphocytic Leukemia |
| title_sort | persistent mixed donor chimerism following double umbilical cord transplantation in a patient with t cell prolymphocytic leukemia |
| url | http://dx.doi.org/10.1155/2019/8437805 |
| work_keys_str_mv | AT ronakhmistry persistentmixeddonorchimerismfollowingdoubleumbilicalcordtransplantationinapatientwithtcellprolymphocyticleukemia AT elizabethohexner persistentmixeddonorchimerismfollowingdoubleumbilicalcordtransplantationinapatientwithtcellprolymphocyticleukemia AT jameskmangan persistentmixeddonorchimerismfollowingdoubleumbilicalcordtransplantationinapatientwithtcellprolymphocyticleukemia |