Novel treatment with rituximab of oropharyngeal posttransplant lymphoproliferative disorder after heart transplantation.
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.
Kaczmarek
Ingo
I
Department of Cardiac Surgery, University Hospital Grosshadern, Ludwig-Maximilians- University, Marchioninistrasse 15, 81377 Munich, Germany.
Beiras-Fernandez
Andres
A
Sadoni
Sebastian
S
Bengel
Dominik
D
Deutsch
Marcus-Andre
MA
Meiser
Bruno
B
Reichart
Bruno
B
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
D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D007155:Immunologic Factors; D007166:Immunosuppressive Agents; D000069283:Rituximab