Post cardiac transplantation lymphoproliferative disorder presenting as t(8;14) Burkitt leukaemia/lymphoma treated with low intensity chemotherapy and rituximab.
BACKGROUND
Post-transplant lymphoproliferative disorder (PTLD) occasionally presents as Burkitt lymphoma/L3 leukaemia (BLL).


METHODS
We reviewed records of cases of PTLD post-cardiac transplantation (1990-2007) occurring in our unit.


RESULTS
There were 15 episodes in 13 patients including four cases of EBV-driven Burkitt-type disease with t(8;14) translocations presenting with advanced stage disease. The first case was treated with a variety of low dose chemotherapy combinations. Despite problems during therapy he obtained complete remission, but died from complications of pre-existing cardiac allograft vasculopathy 7 months later. The subsequent three cases were treated with a UKCCSG low stage lymphoma protocol, NHL 9001 and Rituximab. They remain in complete remission.


CONCLUSIONS
In the context of PTLD the prognostic significance of advanced stage EBV-driven BLL with the t(8;14) translocation may be different to that in immunocompetent children.
Windebank
Kevin
K
Department of Child Health, Newcastle upon Tyne NHS Hospitals Foundation Trust, Newcastle upon Tyne, UK. k.p.windebank@ncl.ac.uk
Walwyn
Tom
T
Kirk
Richard
R
Parry
Gareth
G
Hasan
Asif
A
Bown
Nick
N
Wilkins
Bridget
B
D000293:Adolescent; D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D058846:Antibodies, Monoclonal, Murine-Derived; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D002051:Burkitt Lymphoma / Q000188:drug therapy* / Q000209:etiology / Q000235:genetics; D002648:Child; D002675:Child, Preschool; D002883:Chromosomes, Human, Pair 14; D002898:Chromosomes, Human, Pair 8; D005260:Female; D016027:Heart Transplantation / Q000009:adverse effects*; D006801:Humans; D007223:Infant; D008297:Male; D000069283:Rituximab; D014178:Translocation, Genetic
D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D000069283:Rituximab