Relapsed/refractory PBML complicated with failed platelet implantation and mixed infection after allo-HSCT: A case report.
Ying He, Fangyi Fan, Yingling Zhou et al.
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Case in brief
A 48-year-old woman had refractory non-germinal-center diffuse large B-cell lymphoma arising in the bone marrow, with p53 overexpression, a complex karyotype, and hemophagocytic lymphohistiocytosis. Induction chemotherapy achieved complete remission, followed by autologous stem-cell transplantation; the lymphoma relapsed within 3 months. After salvage therapy and allogeneic transplantation, she developed primary platelet-poor graft function, mixed infections, severe acute intestinal graft-versus-host disease, and progressive marrow stromal necrosis. Despite intensive supportive care, she died from massive gastrointestinal bleeding.
What made this case unusual
The case combined primary platelet-poor graft function and mixed infections after allogeneic transplantation in a patient with primary bone marrow lymphoma, alongside severe intestinal graft-versus-host disease and progressive marrow stromal necrosis.
Diagnostic / clinical pearl
Poor graft function after allogeneic transplantation may occur amid multiple concurrent complications; this report attributed it to multifactorial injury involving adverse disease features and damage to the bone-marrow microenvironment.