Complete regression of cutaneous B-cell lymphoma in a renal transplant patient after conversion from cyclosporin to sirolimus.
Posttransplant lymphoproliferative disease remains a serious morbidity. Herein we have reported a case of complete regression of a biopsy-proven B-cell lymphoma that occurred in the posttransplant period. A 48-year-old man received a living donor renal transplant for end-stage renal disease due to undetermined etiology. His initial immunosuppression consisted of corticosteroid, mycophenolate mofetil, and cyclosporin. The patient developed severe pneumonia within the first 2 months after transplantation due to Acineotobacter, fungus, and cytomegalovirus infections. He experienced a complete recovery and was discharged for regional follow-up. Four months after discharge, he was referred again because of presence of two nodules on his trunk. A biopsy of the nodules revealed B-cell lymphoma. Cyclosporin was stopped and he was converted to sirolimus. The lesions regressed progressively and completely within 7 weeks. The patient remains well without clinical relapses at 19 months after conversion. Renal functions remained stable. We postulated that the antincoplastic properties of sirolimus may have played an active part in the positive outcome.
Mohsin
N
N
Department of Nephrology, Royal Hospital, Muscat, Oman. nabmoh@omantel.net.om
Budruddin
M
M
Kamble
P
P
Khalil
M
M
Pakkyarra
A
A
Jha
A
A
Mohammed
E
E
Ahmed
H
H
Ahmed
J
J
Thomas
S
S
Campistol
J M
JM
Daar
A
A
D001706:Biopsy; D016572:Cyclosporine / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000276:immunology; D016393:Lymphoma, B-Cell / Q000276:immunology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009365:Neoplasm Regression, Spontaneous; D020123:Sirolimus / Q000627:therapeutic use*; D012878:Skin Neoplasms / Q000276:immunology / Q000473:pathology
D007166:Immunosuppressive Agents; D016572:Cyclosporine; D020123:Sirolimus