Table 1.
Overview of events, treatment, scores, paraclinical, and clinical findings
| Date | Clinical events | Treatment | EDSS score | MSIS score | MRI | Oligoclonal bands | CXCL13 | MMP-9 |
|---|---|---|---|---|---|---|---|---|
| 1985 | MS | |||||||
| Nov. 2003 | follicular lymphoma | CVP, FC | ||||||
| June 2006 | CR of lymphoma | 3.5 | 31 | >10 T2 brain lesions, spinal MRI not done | positive | undetectable | undetectable | |
| July 2006 | Allo-HCT | FA, TBI, CsA, MMF1 | ||||||
| Aug. 2006 | CsA, MMF | 3.5 | 30 | |||||
| Jan. 2007 | acute GVHD | MEP, CsA, MMF, Infliximab | ||||||
| April 2007 | CsA, MMF, PSL | 4 | 39 | |||||
| Sept. 2007 | MEP/PSL, MMF, TAC | several new brain lesions and 2 spinal cord lesions | ||||||
| Dec. 2007 | acute GVHD resolved/full donor chimera | MMF, TAC, PSL | ||||||
| July 2008 | chronic GVHD | PSL, TAC, MMF | ||||||
| Aug. 2008 | PSL, TAC, MMF | 1 new brain lesion; 1 spinal cord lesion resolved | negative | 27 pg/ml | undetectable | |||
| Sept. 2008 | CR of lymphoma | PSL, TAC, MMF | ||||||
| Dec. 2008 | PSL, TAC, MMF | 5 | 33 | |||||
| April 2010 | TAC | negative | 24 pg/ml | 1.71 ng/ml | ||||
| June 2010 | TAC | no changes | ||||||
| May 2011 | TAC | 5.5 | 32 |
1
The patient has been receiving immunoglobulin replacement therapy since July 2006 due to hypogammaglobulinemia.
MRI = Magnetic resonance imaging; CXCL13 = C-X-C motif chemokine 13 (undetectable, i.e., <7.8 pg/ml in control subjects); MMP-9 = matrix metalloproteinase-9 (undetectable, i.e., <0.0312 ng/ml in control subjects); GVHD = graft-versus-host disease; CR = complete remission; CVP = cyclophosphamide, vincristine, prednisolone; FC = fludarabine, cyclophosphamide; FA = fludarabine; TBI = total body irradiation; MEP = methylprednisolone; CsA = cyclosporine A; PSL = prednisolone; MMF = mycophenolate mofetil; TAC = tacrolimus.