Treatment of relapsing refractory diffuse large cell lymphoma after matched unrelated donor bone marrow transplant with immunosuppression withdrawal and rituximab.

A 31-year-old man with a diffuse large-cell lymphoma in first refractory relapse received a bone marrow transplant (BMT) from a matched unrelated donor using CAMPATH-1H, carmustine, etoposide, cytarabine and melphalan as conditioning regimen, and methotrexate and tacrolimus for graft-versus-host disease (GVHD) prophylaxis. The transplant was complicated by grade II skin acute GVHD. Lymphoma relapse occurred 4 months post-transplant. Immunosuppression withdrawal plus rituximab induced a complete response. He remains in complete remission (CR) 11 months post-immunosuppression withdrawal and 15 months post-transplant.