Journal of Hematology, ISSN 1927-1212 print, 1927-1220 online, Open Access
Article copyright, the authors; Journal compilation copyright, J Hematol and Elmer Press Inc
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Case Report

Volume 13, Number 5, October 2024, pages 250-258

Allogeneic Hematopoietic Stem Cell Transplantation After Solid Organ Transplantation in Patients With Hematologic Malignancies Managed With Post-Transplant Cyclophosphamide-Based Graft-Versus-Host Disease Prophylaxis

Figure

Figure 1.
Figure 1. Patient timelines. MDS: myelodysplastic syndrome; AML: acute myeloid leukemia; WBC: white blood cell; HSCT: hematopoietic stem cell transplantation; GVHD: graft-vs-host disease; PTLD: post-transplant lymphoproliferative disorder; DLBCL: diffuse large B-cell lymphoma.

Table

Table 1. Patient Characteristics
 
Patient 1Patient 2Patient 3
SOT: solid organ transplantation; HSCT: hematopoietic stem cell transplantation; MDS: myelodysplastic syndrome; AML: acute myeloid leukemia; PTLD: post-transplant lymphoproliferative disorder; DBCL: diffuse large B-cell lymphoma; EBV: Epstein-Barr virus; NMA: non-myeloablative; Flu: fludarabine; Cy: cyclophosphamide; TBI: total body irradiation; HLA: human leukocyte antigen; WBC: white blood cell; GVHD: graft-vs-host disease.
Type of SOTLiverKidneyHeart
Age at SOT, year543131
Indication for SOTPrimary sclerosing cholangitisDiabetic nephropathyViral myocarditis
Solid organ donorCadaverLivingCadaver
Immunosuppression post-SOTTacrolimusSirolimusTacrolimus
Hematologic diagnosis indication for HSCTMDS with progression to AML (trisomy 8)PTLD-DLBCL (EBV negative)Treatment related MDS
Duration SOT to hematologic diagnosis, year2.6722.3
Duration SOT to HSCT, year38.622.8
HSCT conditioning regimenNMA Flu-Cy-TBINMA Flu-Cy-TBIReduced intensity Flu/Bu/Cy/TBI
HSCT donor sourceCord blood - HLA 6/6Peripheral blood - first degree haploidenticalPeripheral blood - first degree haploidentical
Time to engraftment, daysWBC: 44/platelet: 44WBC: 19/platelet: 23WBC: 20/platelet: 31
Immunosuppression post-HSCTMMF and tacrolimusCyclophosphamide, MMF, and tacrolimus to sirolimusCyclophosphamide, MMF, and tacrolimus
Acute GVHDIII (skin)NoneNone
Chronic GVHDYesNoNo
Overall survival from HSCT, months274313
Living statusLoss to follow-upAliveDeceased secondary to relapse
Overall survival from HSCT, months274313
Living statusLoss to follow-upAliveDeceased secondary to relapse