Early Post-Transplant Relapse in a Patient with Transformed Follicular Lymphoma – A Case Report

Abraham SS, Vasudevan JA, Sreemahadevan S, Bharathi JK and Nair SG

Department of Medical Oncology, Regional Cancer Centre, Thiruvananthapuram, India
Department of Pathology, Regional Cancer Centre, Thiruvananthapuram, India

^*Correspondance to: Sreejith G Nair 

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Abstract:

Histological Transformation (HT) in Follicular Lymphoma (FL) to aggressive Diffuse Large B Cell Lymphomas (DLBCL) is a major event in the natural history of indolent lymphomas and has a poor prognosis. Salvage chemotherapy followed by High Dose Therapy (HDT) and Autologous Stem Cell Transplant (ASCT) is the standard treatment. Early relapse following ASCT is rare with limited treatment options. A forty-six-year-old male was diagnosed with Stage IV Non-Hodgkins Lymphoma (NHL), Follicular Grade IIIA, Follicular Lymphoma International Prognostic Index (FLIPI) score-3 and attained metabolic Complete Response (CR) following chemotherapy and radiotherapy to residual nodal disease. Six years later he had disease relapse with HT to DLBCL, Double Expressor (DE) stage IIIA. He underwent salvage chemotherapy and consolidation with ASCT. Three months later he developed thrombocytopenia and non-oliguric renal dysfunction. PET-CT (Positron Emission Tomography) showed multiple hypoattenuating lesions in the liver, left kidney, intraabdominal lymphadenopathy and skeletal lesions. Renal biopsy revealed High grade B cell lymphoma – DE and was diagnosed with early post-transplant relapse in transformed FL. Shortly he developed sepsis with multiorgan dysfunction syndrome and succumbed to the disease. The case is being presented in view of its rarity.

Keywords:

Histological transformation; Double expressor lymphoma; Post-transplant relapse; Transformed follicular lymphoma; Autologous stem cell transplant

Cite the Article:

Abraham SS, Vasudevan JA, Sreemahadevan S, Bharathi JK, Nair SG. Early Post-Transplant Relapse in a Patient with Transformed Follicular Lymphoma – A Case Report. Clin Oncol. 2024;9:2066..