Days −10 to 0: Conditioning regimen of total-body irradiation (1,375 cGy with 600 cGy chest and 300 cGy testes boost), thiotepa, cyclophosphamide, rabbit ATG with KGF; CD34+-selected T-cell–depleted graft

Days 21 to 91: Brincidofovir, 200 mg, weekly (CMV prevention protocol)

Month 6: Recurrence of lymphoma; rituximab and dexamethasone weekly (3 doses)

Month 7: Donor lymphocyte infusion (5 × 106 CD3 cells per kilogram of body weight) and maintenance lenalidomide

Months 10 to 12: GVHD of skin, gut, and liver; high-dose steroids, MMF, alemtuzumab

Month 12: Maintenance MMF, 1 g, twice daily and prednisone, 10 mg/d

Month 15: MMF, 1 g, twice daily and prednisone taper completed

Month 16: Development of AKI

Month 17: MMF taper to 500 mg twice daily

Month 18: MMF discontinued and sirolimus started at 2 mg/d; kidney biopsy consistent with PVAN

Month 19: Brincidofovir, 100 mg, twice weekly

Month 20: Resume MMF, 1 g, twice daily for GVDH

Month 30: Death from bacterial sepsis

Note: Times are relative; T-cell–depleted hematopoietic stem cell transplantation at day 0.

Abbreviations: AKI, acute kidney injury; ATG, antithymocyte globulin; CMV, cytomegalovirus; GVHD, acute graft-versus-host disease; KGF, keratinocyte growth factor; MMF, mycophenolate mofetil; PVAN, polyomavirus-associated nephropathy.