Anti-CD20 monoclonal antibody therapy in Epstein-Barr Virus-associated B cell lymphoma following lung transplantation.
Post-transplant lymphoproliferative disease is a complication of bone marrow and solid organ transplantation, mostly associated with Epstein-Barr virus infection and chronic immunosuppression. Even if spontaneous resolution after cessation of immunosuppressive therapy can be observed, the prognosis of this disorder is usually poor with a low response to specific treatment. We describe a case of B-cell lymphoma of the nasopharynx occurring 6 months after double-lung transplantation. In spite of its monoclonal nature, anti-CD 20 monoclonal antibody given in the presence of reduced immunosuppression resulted in a complete response. The patient also received "consolidation" radiation therapy to prevent the recurrence. The treatment was well tolerated with minimal side effects. The patient was asymptomatic and had a well functioning graft more than 1 year after therapy.
Reynaud-Gaubert
M
M
Department of Thoracic Surgery, University of Marseille Medical Center, Marseille, France. mreynaud@mail.ap-hm.fr
Stoppa
A M
AM
Gaubert
J
J
Thomas
P
P
Fuentes
P
P
D000328:Adult; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D000914:Antibodies, Viral / Q000032:analysis; D018951:Antigens, CD20 / Q000276:immunology*; D001706:Biopsy; D002051:Burkitt Lymphoma / Q000188:drug therapy* / Q000209:etiology; D004279:DNA, Viral / Q000032:analysis; D004359:Drug Therapy, Combination; D004854:Herpesvirus 4, Human / Q000235:genetics / Q000276:immunology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016040:Lung Transplantation / Q000009:adverse effects*; D008297:Male; D009303:Nasopharyngeal Neoplasms / Q000188:drug therapy* / Q000209:etiology; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D016133:Polymerase Chain Reaction; D014057:Tomography, X-Ray Computed
D000911:Antibodies, Monoclonal; D000914:Antibodies, Viral; D018951:Antigens, CD20; D004279:DNA, Viral; D007166:Immunosuppressive Agents