Mini-BEAM and autologous hematopoietic stem-cell transplant for treatment of post-transplant lymphoproliferative disorders.
Post-transplant lymphoproliferative disorder (PTLD) represents a spectrum of lymphoid proliferative diseases seen as result of immunosuppression in recipients of solid organ or hematopoietic stem-cell transplantation. Options of treatment include reduction or discontinuation of immunosuppressive agents, antiviral drugs, rituximab, chemotherapy, and radiation. We report two unique cases of PTLD (CNS and plasmacytoma-like) treated successfully with salvage chemotherapy, mini-BEAM chemotherapy, and autologous stem-cell transplant. In both cases, patients were also treated with sirolimus and prednisone as immunosuppression, and neither patient rejected their solid organ transplants. With over 30 months of follow-up, both patients remain in complete remission with excellent allograft function.
Department of Medicine, University of Cincinnati and Veterans Administration Medical Center, Cincinnati, Ohio 45267, USA. komrokrs@ucmail.uc.edu
Rami S
RS
Komrokji
Jamie L
JL
Oliva
Martin
M
Zand
Raymond
R
Felgar
Camille N
CN
Abboud
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002330:Carmustine / Q000627:therapeutic use; D003561:Cytarabine / Q000627:therapeutic use; D005047:Etoposide / Q000627:therapeutic use; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects; D008232:Lymphoproliferative Disorders / Q000209:etiology / Q000628:therapy*; D008297:Male; D008558:Melphalan / Q000627:therapeutic use; D008875:Middle Aged; D016879:Salvage Therapy; D014182:Transplantation, Autologous; D019737:Transplants / Q000009:adverse effects*
D003561:Cytarabine; D005047:Etoposide; D008558:Melphalan; D002330:Carmustine