Myositis, polyserositis with a large pericardial effusion and constrictivepericarditis as manifestations of chronic graft-versus-host disease after non-myeloablative peripheral stem cell transplantation and subsequent donorlymphocyte infusion

The clinical features of chronic graft-versus-host disease (cGVHD) followin g a non-myeloablative peripheral blood stem cell (PBSC) transplant may diff er from those that occur after a conventional allograft, We describe a man with Hodgkin's disease refractory to chemotherapy and radiotherapy who was transplanted from an HLA-identical brother, who developed cGVHD characteris ed, in particular, by polymyositis, polyserositis with a large pericardial effusion and constrictive pericarditis, 1 month after donor lymphocyte infu sion for relapsed disease. Constrictive pericarditis has not been previousl y reported after a conventional allograft, and none of these features have been reported after a non-myeloablative transplant. The course of cGVHD nec essitated potent immunosuppression leading to the presumed loss of graft-ve rsus-lymphoma (GVL) effect.