Successful treatment of post-transplant lymphoproliferative disorder in autologous blood stem cell transplant recipients.
We report three cases of post-transplant lymphoproliferative disorder (PTLD) in the context of autologous stem cell transplantation (ASCT) for multiple myeloma (MM) and non-Hodgkin's lymphoma. The first two cases received ASCT for MM, one with a CD34-selected autograft and the other with an unmanipulated autograft. Both these cases of PTLD achieved a complete response following treatment with IVIG, gancyclovir, solumedrol and interferon (IFN). The third case received ASCT with an unmanipulated autograft for relapsed angioimmunoblastic lymphoma. He also achieved a complete response but only after rituximab was added to IVIG, gancyclovir, solumedrol and IFN. None of these patients experienced a relapse of their PTLD with follow-up ranging from 1.5 to 5 years. These cases highlight the importance of considering PTLD in the differential diagnosis of lymphadenopathy and fever post ASCT. They also demonstrate the possibility of durable complete remission of post-ASCT PTLD following antiviral and immune modulating therapy.
Jenkins
D
D
Department of Medicine, University of Calgary and Tom Baker Cancer Center, Calgary, Alberta, Canada.
DiFrancesco
L
L
Chaudhry
A
A
Morris
D
D
Glück
S
S
Jones
A
A
Woodman
R
R
Brown
C B
CB
Russell
J
J
Stewart
D A
DA
D000328:Adult; D000970:Antineoplastic Agents / Q000008:administration & dosage; D000998:Antiviral Agents / Q000008:administration & dosage; D003937:Diagnosis, Differential; D006801:Humans; D007119:Immunoblastic Lymphadenopathy / Q000150:complications / Q000628:therapy; D007167:Immunotherapy; D008228:Lymphoma, Non-Hodgkin / Q000150:complications / Q000628:therapy; D008232:Lymphoproliferative Disorders / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications / Q000628:therapy; D036102:Peripheral Blood Stem Cell Transplantation / Q000009:adverse effects*; D012074:Remission Induction / Q000379:methods; D014182:Transplantation, Autologous / Q000009:adverse effects
D000970:Antineoplastic Agents; D000998:Antiviral Agents