title: Novel treatment with rituximab of oropharyngeal posttransplant lymphoproliferative disorder after heart transplantation.
abstract: Posttransplant lymphoproliferative disorders are severe complications that arise after solid organ transplantation, which are often related to Epstein- Barr virus. Reports are anecdotal, and a standardized therapy does not exist. We report a case of a 36-year-old man who developed posttransplant lymphoproliferative disorder of the oropharynx 1 year after receiving a heart transplant. A short review of the literature is presented, after which a new therapeutic approach that combines antiviral therapy, monoclonal antibodies, and a sirolimus-based maintenance immunosuppression regimen with reduced target trough levels of tacrolimus is introduced. The patient achieved complete remission and was free from recurrence 18 months after the therapy was initiated.
authors.affiliation: Department of Cardiac Surgery, University Hospital Grosshadern, Ludwig-Maximilians- University, Marchioninistrasse 15, 81377 Munich, Germany.
authors.forename: Ingo
authors.initials: I
authors.lastname: Kaczmarek
authors.forename: Andres
authors.initials: A
authors.lastname: Beiras-Fernandez
authors.forename: Sebastian
authors.initials: S
authors.lastname: Sadoni
authors.forename: Dominik
authors.initials: D
authors.lastname: Bengel
authors.forename: Marcus-Andre
authors.initials: MA
authors.lastname: Deutsch
authors.forename: Bruno
authors.initials: B
authors.lastname: Meiser
authors.forename: Bruno
authors.initials: B
authors.lastname: Reichart
mesh_terms: D000328:Adult; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D058846:Antibodies, Monoclonal, Murine-Derived; D016027:Heart Transplantation / Q000009:adverse effects; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use*; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D008232:Lymphoproliferative Disorders / Q000188:drug therapy* / Q000209:etiology; D008297:Male; D009960:Oropharynx; D000069283:Rituximab
chemical_list: D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D007155:Immunologic Factors; D007166:Immunosuppressive Agents; D000069283:Rituximab