Posttransplantation course after allogeneic stem cell transplantation in a patient with advanced mycosis fungoides—Balancing relapse and rejection

Abstract

Treatment of advanced cutaneous T-cell lymphoma (CTCL) can be challenging. To date, the only potentially curative treatment option for advanced CTCL is allogeneic hematopoietic stem cell transplantation. We report on a patient with mycosis fungoides who received allogeneic hematopoietic stem cell transplantation due to rapid progression of the disease. Eight months after transplantation, relapse as well as chronic graft-versus-host disease occurred. Therefore, we initiated different treatment modalities, including bexarotene, extracorporeal photopheresis, topical treatment as well as the Janus-kinase-inhibitor Ruxolitinib. Even though the patient experienced high morbidity due to the allogeneic hematopoietic stem cell transplantation, 3 years after he is still alive and reports good health-related quality of life. With this case, we aim to demonstrate that the posttransplant course can be difficult, balancing between relapse and graft-versus-host disease. Nevertheless, patients can benefit in terms of survival and their health-related quality of life. Therefore, allogeneic hematopoietic stem cell transplantation should be considered as a treatment option, especially for patients with advanced CTCL and poor prognosis.