Concurrent application of blinatumomab and haploidentical donor
leukocyte infusions for refractory primary mediastinal large B-cell
lymphoma
Abstract
Primary mediastinal large B-cell lymphoma (PMBCL) is a rare hematologic
malignancy with distinct clinical and immunopathological features. We
report a case of a young adult male with disease refractory to multiple
lines of therapy, including CAR-T cells, who achieved his first complete
remission after haploidentical BMT, following donor leukocyte infusions
(DLI) given concurrently with blinatumomab. While DLI has been used
after T-replete haplo-BMT with PT-CY, there are no reports on its use
for PMBCL. Similarly, blinatumomab is active against B-cell lymphomas,
but literature is lacking in patients with PMBCL. Our experience
illustrates that blinatumomab can be used concurrently with DLI in a
haploidentical setting to achieve disease response in PMBCL. Despite our
encouraging experience with this case, we would not recommend this
approach outside of a clinical trial as blinatumomab may exacerbate the
GvHD risks of DLI especially in a haploidentical setting.