title: Sirolimus-induced remission of posttransplantation lymphoproliferative disorder.
abstract: Posttransplantation lymphoproliferative disorder (PTLD) is one of the most serious complications of solid-organ transplantation. It potentially is treatable in most cases, but current methods involve withdrawal or reduction of immunosuppression and the consequent risk for graft rejection. Sirolimus was shown in vivo and in vitro to limit proliferation of a number of malignant cell lines, including those of PTLD-derived cells. We present a case of disseminated PTLD in a patient with a renal transplant that resolved completely with conversion of immunosuppression to sirolimus. Graft function was maintained and improved with treatment. This offers a novel means of treating these patients and minimizing transplant loss.
authors.affiliation: Renal Unit, Royal Devon and Exeter Foundation Trust, Exeter, UK. brett.cullis@rdehc-tr.swest.nhs.uk
authors.forename: Brett
authors.initials: B
authors.lastname: Cullis
authors.forename: Richard
authors.initials: R
authors.lastname: D'Souza
authors.forename: Paul
authors.initials: P
authors.lastname: McCullagh
authors.forename: Simon
authors.initials: S
authors.lastname: Harries
authors.forename: Anthony
authors.initials: A
authors.lastname: Nicholls
authors.forename: Richard
authors.initials: R
authors.lastname: Lee
authors.forename: Coralie
authors.initials: C
authors.lastname: Bingham
mesh_terms: D000328:Adult; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D016030:Kidney Transplantation / Q000009:adverse effects*; D008232:Lymphoproliferative Disorders / Q000188:drug therapy* / Q000209:etiology* / Q000473:pathology; D008297:Male; D012074:Remission Induction; D020123:Sirolimus / Q000627:therapeutic use*
chemical_list: D007166:Immunosuppressive Agents; D020123:Sirolimus