Salvage Chemotherapy Followed by Autologous Stem-Cell Transplantation Using Targeted Busulfan for Refractory Diffuse Large B-Cell Lymphoma With Dialysis-Dependent End-Stage Renal Disease

Clin Lymphoma Myeloma Leuk. 2020 Feb;20(2):e92-e96. doi: 10.1016/j.clml.2019.11.004. Epub 2019 Nov 7.


Background: A treatment strategy is needed for hemodialysis-dependent patients with end-stage renal disease who have relapsed/refractory diffuse large B-cell lymphoma (DLBCL). We examined the feasibility of salvage chemotherapy followed by autologous stem-cell transplantation (ASCT) and busulfan as a conditioning regimen.

Patients and methods: We provided a patient with refractory DLBCL who was receiving hemodialysis with modified salvage chemotherapies that were based on the mechanism of drug pharmacokinetics and an evaluation of the pharmacokinetics of busulfan. After chemotherapy, the patient underwent ASCT.

Results: The regimen was successfully administered without adverse events.

Conclusion: Chemotherapy followed by ASCT using a conditioning regimen of reduced melphalan and pharmacokinetically targeted busulfan is a promising strategy for treating patients with relapsed or refractory DLBCL who also have end-stage renal disease and are receiving hemodialysis.

Keywords: Ascites; CHASER; DLBCL; Hemodialysis; R-GDC.

Publication types

  • Case Reports

MeSH terms

  • Busulfan / pharmacology
  • Busulfan / therapeutic use*
  • Humans
  • Kidney Failure, Chronic / drug therapy*
  • Kidney Failure, Chronic / etiology*
  • Kidney Failure, Chronic / mortality
  • Lymphoma, Large B-Cell, Diffuse / complications*
  • Lymphoma, Large B-Cell, Diffuse / drug therapy*
  • Lymphoma, Large B-Cell, Diffuse / mortality
  • Male
  • Middle Aged
  • Renal Dialysis
  • Salvage Therapy / methods*
  • Survival Analysis


  • Busulfan