Allogeneic hematopoietic stem cell transplantation achieves complete response in refractory primary mediastinal large B-cell lymphoma after the failure of chemotherapy, CAR-T therapy, and PD-1 blockade.
Tatsuya Suwabe, Yuri Furuyama, Ayako Kawakami et al.
✦ AI-curated · Sources linked
Case in brief
A 19-year-old female with refractory primary mediastinal large B-cell lymphoma (PMBCL) experienced a central nervous system relapse after partial response to chemotherapy. Following treatment with high-dose methotrexate and radiotherapy, she developed hepatic lesions resistant to CAR-T therapy and pembrolizumab. Allogeneic hematopoietic stem cell transplantation led to a complete response, although she later succumbed to a disseminated infection.
What made this case unusual
The case illustrates the successful use of allogeneic hematopoietic stem cell transplantation in a patient with PMBCL refractory to multiple lines of immunotherapy, highlighting the potential for curative treatment in challenging cases.
Diagnostic / clinical pearl
Clinicians should consider allogeneic hematopoietic stem cell transplantation as a viable option for PMBCL patients who do not respond to conventional therapies and multiple immunotherapies.
Why it matters
This case underscores the importance of evaluating pre-transplant therapies, such as pembrolizumab and localized radiotherapy, as they may impact transplant outcomes in refractory PMBCL.