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Medical Oncology

, Volume 15, Issue 4, pp 279–281 | Cite as

Combined radiation and chemotherapy in posttransplant lymphoproliferative disorder

  • Donald E Tsai
  • Edward A Stadtmauer
  • Daniel J Canaday
  • David J Vaughn
Case Report

Abstract

The optimal treatment for posttransplant lymphoproliferative disorder which has progressed despite a reduction in immunosuppression has not been defined. We report on two patients with stage I posttransplant lymphoproliferative disorder who developed progressive disease despite a reduction in the level of immunosuppression. Both patients were treated with combined short course CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) chemotherapy followed by involved-field radiation therapy. In both patients, a rapid response was obtained followed by complete remission. Combined modality therapy can be utilized successfully in progressive limited stage posttransplant lymphoproliferative disorder.

Keywords

posttransplant lymphoproliferative disorder chemotherapy radiation therapy 

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References

  1. 1.
    Morrison VAet al. Clinical characteristics of posttransplant lymphoproliferative disorders.Am J Med 1994;97: 14–24.PubMedCrossRefGoogle Scholar
  2. 2.
    Starzl TEet al. Reversibility of lymphomas and lymphoproliferative lesions developing under cyclosporine-steroid therapy.Lancet 1984;8377: 583–587.CrossRefGoogle Scholar
  3. 3.
    Swinnen LJet al. Aggressive treatment for postcardiac transplant lymphoproliferation.Blood 1995;86: 3333–3340.PubMedGoogle Scholar
  4. 4.
    Leblond Vet al. Lymphoproliferative disorders after organ transplantation: a report of 24 cases observed in a single center.J Clin Oncol 1995;13: 961–968.PubMedGoogle Scholar
  5. 5.
    McKelvey EMet al. Hydroxyldaunomycin (adriamycin) combination chemotherapy in malignant lymphoma.Cancer 1976;38: 1484–1493.PubMedCrossRefGoogle Scholar
  6. 6.
    Nalesnik MA. Posttransplantation lymphoproliferative disorders (PTLD) current perspectives.Sem Thorac Cardiovasc Surg 1996;8: 139–148.Google Scholar
  7. 7.
    Savoie Aet al. Direct correlation between the load of Epstein-Barr virus-infected lymphocytes in the peripheral blood of pediatric transplant patients and risk of lymphoproliferative disease.Blood 1994;83: 2715–2722.PubMedGoogle Scholar
  8. 8.
    Hanson MNet al. Posttransplant T-cell lymphoproliferative disorders—an aggressive, late complication of solid-organ transplantation.Blood 1996;88: 3626–3633.PubMedGoogle Scholar
  9. 9.
    Alfrey EJet al. A recent decrease in the time to development of monomorphous and polymorphous posttransplant lymphoproliferative disorder.Transplantation 1992;54: 250–253.PubMedCrossRefGoogle Scholar
  10. 10.
    Oda Det al. Oral presentation of posttransplantation lymphoproliferative disorder.Transplantation 1996;61: 435–440.PubMedCrossRefGoogle Scholar
  11. 11.
    Pirsch Jet al. Treatment of severe Epstein-Barr virus-induced lymphoproliferative syndrome with ganciclovir: two cases after solid organ transplantation.Am J Med 1989;86: 241–244.PubMedCrossRefGoogle Scholar
  12. 12.
    Antoine Cet al. Successful treatment of posttransplant lymphoproliferative disorder with renal graft preservation bymonoclonal antibody therapy.Transplant Proc 1996;28: 2825–2826.PubMedGoogle Scholar
  13. 13.
    Lazarovits AIet al. Anti-B cell antibodies for the treatment of monoclonal Epstein-Barr virus-induced lymphoproliferative syndrome after multivisceral transplantation.Clin Invest Med 1994;17: 621–625.PubMedGoogle Scholar
  14. 14.
    Fischer Aet al. Anti-B-cell monoclonal antibodies in the treatment of severe B-cell lymphoproliferative syndrome following bone marrow and organ transplantation.N Engl J Med 1991;324: 1451–1456.PubMedCrossRefGoogle Scholar
  15. 15.
    O'Brien Set al. Remission of posttransplant lymphoproliferative disorder after interferon alfa therapy.J Am Soc Nephrol 1996;8: 1483–1490.Google Scholar
  16. 16.
    Nalesnik MAet al. Autologous lymphokine-activated killer cell therapy of lymphoproliferative disorders arising in organ transplant recipients.Transplant Proc 1997;29: 1905–1906.PubMedCrossRefGoogle Scholar
  17. 17.
    Emanuel Det al. Treatment of posttransplant lymphoproliferative disease in the central nervous system of a lung transplant recipient using allogeneic leukocytes.Transplantation 1997;63: 1691–1694.PubMedCrossRefGoogle Scholar
  18. 18.
    Garrett TJet al. Posttransplantation lymphoproliferative disorders treated with cyclophosphamide-doxorubicinvincristine-prednisone chemotherapy.Cancer 1993;72: 2782–2785.PubMedCrossRefGoogle Scholar
  19. 19.
    Miller Tet al. Chemotherapy alone compared with chemotherapy plus radiography for localized intermediate and high-grade non-Hodgkin's lymphoma.N Engl J Med 1998;339: 21–26.PubMedCrossRefGoogle Scholar
  20. 20.
    Tondini Cet al. Combined modality treatment with Primary CHOP chemotherapy followed by locoregional irradiation in stage I or II histologically aggressive non-Hodgkin's lymphoma.J Clin Oncol 1993;11: 720–725.PubMedGoogle Scholar

Copyright information

© Stockton Press 1998

Authors and Affiliations

  • Donald E Tsai
    • 1
  • Edward A Stadtmauer
    • 1
  • Daniel J Canaday
    • 2
  • David J Vaughn
    • 1
  1. 1.Hematology-Oncology DivisionUniversity of Pennsylvania Medical CenterPhiladelphiaUSA
  2. 2.Department of Radiation OncologyUniversity of Pennsylvania Medical CenterPhiladelphiaUSA

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