LOCALIZED, LATE-ONSET, HIGH-GRADE LYMPHOMA FOLLOWING BONE-MARROW TRANSPLANTATION - RESPONSE TO COMBINATION CHEMOTHERAPY

Non-Hodgkin's lymphoma is the commonest secondary cancer following bon e marrow transplantation (BMT). We report the case of a 42-year-old ma n who developed a laryngeal high-grade B-cell lymphoma 5 years followi ng a matched T depleted BMT for CML. Polymerase chain reaction (PCR) a nalysis using the microsatellite marker Cyp 19 demonstrated the donor origin of involved tissue. Epstein-Barr virus (EBV) genomic sequences were identified by PCR. Although EBV related B-cell lymphoproliferativ e disorders (BLPD) post BMT are difficult to treat, there was a comple te remission in this patient following three courses of chemotherapy ( CHOP) administered with G-CSF. This case of late-onset BLPD appears cl inically distinct from the well-defined, aggressive early post-transpl ant BLPD.