title: Treatment of postrenal transplantation lymphoproliferative disease manifesting as plasmacytoma with nonmyeloablative hematopoietic stem cell transplantation from the same kidney donor.
abstract: Posttransplantation lymphoproliferative disease (PTLD) presenting as an Epstein-Barr-virus (EBV)-related nasal plasmacytoma developed in a renal-allograft recipient 13 years after transplantation. Systemic dissemination occurred despite immunosuppression withdrawal, surgery, irradiation, and chemotherapy. A nonmyeloablative hematopoietic-stem-cell-transplantation (HSCT) with peripheral blood HSC from the kidney donor was performed. With the onset of graft-versus-host disease, resolution of the systemic disease was demonstrated clinically and molecularly by serial quantification of plasma EBV-DNA. Isolated relapse occurred in the central nervous system (CNS), a known tumour sanctuary site, ultimately leading to death. Nonmyeloablative HSCT might be considered a cellular therapy for PTLD, but possible CNS relapse must be effectively tackled.
authors.affiliation: University Department of Medicine, Queen Mary Hospital, Hong Kong.
authors.forename: W Y
authors.initials: WY
authors.lastname: Au
authors.forename: A K W
authors.initials: AK
authors.lastname: Lie
authors.forename: E C
authors.initials: EC
authors.lastname: Chan
authors.forename: A
authors.initials: A
authors.lastname: Pang
authors.forename: S K
authors.initials: SK
authors.lastname: Ma
authors.forename: C
authors.initials: C
authors.lastname: Choy
authors.forename: Y L
authors.initials: YL
authors.lastname: Kwong
mesh_terms: D000368:Aged; D001932:Brain Neoplasms / Q000556:secondary; D003937:Diagnosis, Differential; D017809:Fatal Outcome; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D004854:Herpesvirus 4, Human; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D008232:Lymphoproliferative Disorders / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy / Q000821:virology; D008297:Male; D009669:Nose Neoplasms / Q000209:etiology / Q000473:pathology / Q000628:therapy / Q000821:virology; D010954:Plasmacytoma / Q000175:diagnosis*; D014019:Tissue Donors