Tailored chemotherapy for malignant lymphoma arising in the setting of posttransplant lymphoproliferative disorder after solid organ transplantation.
Posttransplant lymphoproliferative disorder is a clinical challenge. Traditional chemotherapy results in tumor response, but toxicity and transplant rejection limit survival. The authors treated seven patients with malignant lymphoma after organ transplant with chemotherapy tailored to individual patient response. Chemotherapy consisted of vincristine, cyclophosphamide, and prednisone, with or without doxorubicin (Adriamycin; Pharmacia & Upjohn, Peapack, NJ, U.S.A.), or the ProMACE-CytaBOM regimen. Six of seven patients (86%) showed a complete response to treatment, with five of seven (71%) alive disease-free at 9 to 72 months (mean 38.2) after treatment. The results show that chemotherapy tailored to individual patient response is a safe and effective therapy for malignant lymphoma arising in patients with posttransplant lymphoproliferative disorder.
Watts
Raymond G
RG
Division of Hematology-Oncology, Department of Pediatrics, The University of Alabama at Birmingham, 1600 7th Avenue South, ACC 512, Birmingham, AL 35233, USA. rwatts@peds.uab.edu
Hilliard
Lee M
LM
Berkow
Roger L
RL
D000465:Algorithms; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage; D001761:Bleomycin / Q000008:administration & dosage; D002051:Burkitt Lymphoma / Q000188:drug therapy / Q000209:etiology; D017024:Chemotherapy, Adjuvant; D002648:Child; D002675:Child, Preschool; D003520:Cyclophosphamide / Q000008:administration & dosage; D003561:Cytarabine / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D020031:Epstein-Barr Virus Infections; D005047:Etoposide / Q000008:administration & dosage; D017809:Fatal Outcome; D005260:Female; D016027:Heart Transplantation; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects; D016030:Kidney Transplantation; D008175:Lung Neoplasms / Q000188:drug therapy / Q000209:etiology; D016483:Lymphoma, AIDS-Related / Q000188:drug therapy; D016393:Lymphoma, B-Cell / Q000188:drug therapy* / Q000209:etiology / Q000401:mortality; D016403:Lymphoma, Large B-Cell, Diffuse / Q000188:drug therapy / Q000209:etiology; D008232:Lymphoproliferative Disorders / Q000209:etiology*; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage; D011183:Postoperative Complications / Q000188:drug therapy* / Q000209:etiology; D011241:Prednisone / Q000008:administration & dosage; D012074:Remission Induction; D013274:Stomach Neoplasms / Q000188:drug therapy / Q000209:etiology; D016019:Survival Analysis; D016896:Treatment Outcome; D014750:Vincristine / Q000008:administration & dosage
D003561:Cytarabine; D001761:Bleomycin; D014750:Vincristine; D005047:Etoposide; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone; D008727:Methotrexate