Low-dose pembrolizumab induced complete radiologic and molecular response of posttransplant lymphoproliferative disorder presenting as classical Hodgkin lymphoma
Posttransplant lymphoproliferative disorders (PTLD) are a group of lymphoid diseases in organ allograft recipients . Immunosuppression for preventing graft rejection (solid-organ allografting) or graft-versus-host disease (GVHD) (allogeneic hematopoietic stem cell transplantation, allo-HSCT) suppresses immunosurveillance, predisposing to lymphoproliferative disorders . Pathogenesis is predominantly related to Epstein-Barr virus (EBV) infection of abnormal lymphoid cells.
A 21-year-old man presented in 2005 with recurrent hepatitis and photosensitivity. Subsequent investigations confirmed the diagnosis of erythropoietic protoporphyria. Liver biopsies showed progressive septal fibrosis. He underwent a 10/10 matched unrelated donor HSCT (MUD-HSCT) from a female donor (conditioning: fludarabine, cyclophosphamide, total body irradiation, rabbit antithymocyte globulin) in September 2011. However, donor chimerism declined and was totally lost by 14 months post-HSCT. He...
J.P.Y. Sim: treated the patient, wrote and approved the manuscript
Rex Au-Yeung: performed the histopathological examination, wrote and approved the manuscript
Y.L. Kwong: treated the patient, wrote and approved the manuscript
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
Statement of informed consent
Patient gave informed consent to treatment.
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