Complete remission and proviral load negativization after allogeneic-SCT in a patient with Adult T-cell lymphoma: Case report

Adult T-cell lymphoma is an aggressive and poor prognosis HTLV1-associated lymphoma. There is no standard treatment, but it is known that intensive chemotherapy regimens are necessary, with or without concomitant antiretroviral therapy, plus consolidation with allogeneic stem cell transplantation. Our case report shows a favorable outcome after 2 cycles of chemotherapy and allogeneic stem cell transplantation without antiretroviral agents, achieving complete remission, and a negative proviral load.

Clinical Outcomes after Allogeneic Stem Cell Transplantation for Adult Lymphoblastic Lymphoma

Lymphoblastic lymphoma (LBL) is a rare subtype of non-Hodgkin lymphoma. There are limited reports on allogeneic stem cell transplantation (allo-SCT) in patients with LBL. We retrospectively analyzed the clinical outcomes of 15 adult patients with LBL who received allo-SCT at our institution. The median age at allo-SCT was 29 years (range, 18-42). Disease status at the time of transplantation was complete remission (CR), partial remission (PR), and advanced disease in 4, 4, and 7 patients, respectively. The median follow-up duration of survivors was 25 months (range, 6-106). The probabilities of overall survival (OS) and progression-free survival (PFS) at 2 years after allo-SCT were 37% and 24%, respectively. The respective 2-year OS and PFS rates of the 8 patients with CR or PR at the time of transplantation were 57% and 45%, while those with advanced disease were 14% and 0%. In conclusion, the treatment outcomes of allo-SCT in patients with LBL were unsatisfactory. Although outcomes were promising in patients with CR or PR at the time of transplantation, they were dismal in patients with progressive disease. Further advances in chemotherapy, both induction and salvage therapies, are needed to improve the clinical outcomes of patients with LBL.

FUS-ERG gene fusion in isolated myeloid sarcoma showing uncommon clinical features

FUS-ERG gene fusion has not been reported in cases of myeloid sarcoma (MS), a subtype of acute myeloid leukemia involving extramedullary anatomic sites. Here, we report a case of a 48-year-old man with primary isolated MS of the anterior mediastinum, who later developed multiple extramedullary recurrences without bone marrow infiltration throughout the course. G-banding analysis of the cells in pericardial effusion at recurrence showed complex karyotypic abnormalities including t(16;21)(p11.2;q22). FUS break-apart fluorescent in situ hybridization analysis showed split signals in biopsy sections at initial diagnosis and recurrence. Reverse transcriptase polymerase chain reaction and direct sequencing demonstrated the presence of the FUS-ERG chimeric gene transcript. The patient underwent cord blood transplantation, but died of pneumonia on day 64. To our knowledge, this is the first report of isolated MS carrying FUS-ERG gene fusion. In future study, relationship between the fusion gene and uncommon clinical features should be investigated in isolated MS.