title: Successful treatment of a child with late-onset T-cell post-transplant lymphoproliferative disorder/lymphoma.
abstract: We report a novel regimen for refractory post-transplant T-cell lymphoma (PTL). Our patient presented with non-Epstein-Barr virus (EBV) related, T-cell post-transplant lymphoproliferative disease (PTLD) 3.5 years after liver transplantation. Initially diagnosed as polyclonal PTLD, the disease progressed to a monoclonal, T-cell PTL that was refractory to several chemotherapy regimens but responded to a regimen consisting of fludarabine, cyclophosphamide, cytarabine, and alemtuzumab. Consolidation therapy included high-dose chemotherapy, autologous hematopoietic stem cell rescue, and radiation therapy. She remains in remission 2.5 years later. T-cell PTL is a rare disease with a poor prognosis; this regimen provides a novel, potentially curative approach for its treatment.
authors.affiliation: Department of Pediatrics and Oncology, Johns Hopkins University School of Medicine, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland, USA.
authors.forename: Kirsten M
authors.initials: KM
authors.lastname: Williams
authors.forename: Meghan A
authors.initials: MA
authors.lastname: Higman
authors.forename: Allen R
authors.initials: AR
authors.lastname: Chen
authors.forename: Cindy L
authors.initials: CL
authors.lastname: Schwartz
authors.forename: Moody
authors.initials: M
authors.lastname: Wharam
authors.forename: Paul
authors.initials: P
authors.lastname: Colombani
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Arceci
mesh_terms: D000074323:Alemtuzumab; D000911:Antibodies, Monoclonal / Q000008:administration & dosage; D061067:Antibodies, Monoclonal, Humanized; D000912:Antibodies, Neoplasm / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D001656:Biliary Atresia / Q000601:surgery; D016190:Carboplatin / Q000008:administration & dosage; D002330:Carmustine / Q000008:administration & dosage; D003520:Cyclophosphamide / Q000008:administration & dosage; D003561:Cytarabine / Q000008:administration & dosage; D018450:Disease Progression; D004317:Doxorubicin / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000009:adverse effects; D016031:Liver Transplantation; D016411:Lymphoma, T-Cell, Peripheral / Q000188:drug therapy / Q000209:etiology / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D008232:Lymphoproliferative Disorders / Q000209:etiology / Q000628:therapy*; D008558:Melphalan / Q000008:administration & dosage; D015080:Mesna / Q000008:administration & dosage; D011183:Postoperative Complications / Q000188:drug therapy / Q000209:etiology / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D011241:Prednisone / Q000008:administration & dosage; D018714:Radiotherapy, Adjuvant; D014182:Transplantation, Autologous; D014740:Vidarabine / Q000008:administration & dosage / Q000031:analogs & derivatives; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000912:Antibodies, Neoplasm; D007166:Immunosuppressive Agents; D003561:Cytarabine; D016179:Granulocyte Colony-Stimulating Factor; D000074323:Alemtuzumab; D014750:Vincristine; D005047:Etoposide; D004317:Doxorubicin; D003520:Cyclophosphamide; D016190:Carboplatin; D014740:Vidarabine; D015080:Mesna; C024352:fludarabine; D008558:Melphalan; D002330:Carmustine; D007069:Ifosfamide; D011241:Prednisone