Extracorporeal photochemotherapy for Epstein-Barr virus-associated lymphoma after lung transplantation.
Posttransplantation lymphoproliferative disorder (PTLD) is a serious complication after transplantation of solid organs. Highest incidence rates have been reported for lung transplant recipients. With the current treatment strategy for early onset PTLD, a reduction of immunosuppressive drugs, mortality of lung transplant recipients with PTLD remains high, due to both, incomplete control of PTLD and transplant rejection. We present a lung transplant recipient with a history of acute rejection and Epstein Barr virus-associated posttransplantation malignant non-Hodgkin's lymphoma. Extracorporeal photochemotherapy, in combination with a moderate reduction of immunosuppressive therapy, resulted in complete disappearance of PTLD. After a first year of follow-up, no further rejection and no recurrence of PTLD have occurred. Treatment with ECP, with its beneficial effects on both, rejection after organ transplantation and malignant lymphoma, may be a particularly valuable approach for the treatment of PTLD in patients after lung transplantation, with its increased risk for transplant rejection.
Schoch
O D
OD
Department of Internal Medicine, University Hospital Zurich, Switzerland.
Boehler
A
A
Speich
R
R
Nestle
F O
FO
D000293:Adolescent; D020031:Epstein-Barr Virus Infections / Q000188:drug therapy*; D005260:Female; D006084:Graft Rejection / Q000188:drug therapy / Q000517:prevention & control; D004854:Herpesvirus 4, Human; D006801:Humans; D016040:Lung Transplantation / Q000009:adverse effects*; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy* / Q000821:virology*; D017893:Photopheresis / Q000379:methods*