title: Conservative management of post-transplant central nervous system lymphoma.
abstract: Primary CNS lymphoma (PCNSL) is a rare B cell variant non-Hodgkins lymphoma that is confined to the brain, leptomeninges, spinal cord and eyes. Its incidence is increasing, primarily due to increase in the number of organ transplantations being undertaken. The majority of the PTLD (post-transplant lymphoproliferative disorder) is seen in kidney transplant recipients simply because they constitute a larger group of transplant recipients each year as compared to other solid organ transplantations. Primary infection of previously infected EBV seronegative patients and immunosuppression are found to be the main etiologic factors in the development of PTLD-PCNSL. There are no clear guidelines on treatment regimens, and it should be individualized according to patient comorbidities. We report a case of PCNS lymphoproliferative disorder in a kidney transplant recipient, which underwent complete remission with decreasing immunosuppression. The patient could not undergo chemotherapy/radiotherapy due to underlying comorbidities. We highlight the available treatment modalities for PTLD-PCNSL.
authors.affiliation: University of Toledo Medical Center, Toledo, OH 43614, USA. shahul.valavoor@utoledo.edu
authors.forename: Shahul H
authors.initials: SH
authors.lastname: Valavoor
authors.forename: Zubair
authors.initials: Z
authors.lastname: Ashraf
authors.forename: Rawan
authors.initials: R
authors.lastname: Narwal
authors.forename: Shobha
authors.initials: S
authors.lastname: Ratnam
mesh_terms: D001707:Biopsy, Needle; D002051:Burkitt Lymphoma / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D016543:Central Nervous System Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D020031:Epstein-Barr Virus Infections / Q000150:complications / Q000175:diagnosis*; D005260:Female; D005500:Follow-Up Studies; D004854:Herpesvirus 4, Human / Q000302:isolation & purification; D006801:Humans; D007150:Immunohistochemistry; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000601:surgery*; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000379:methods; D008228:Lymphoma, Non-Hodgkin / Q000209:etiology / Q000473:pathology / Q000628:therapy; D008232:Lymphoproliferative Disorders / Q000209:etiology / Q000473:pathology / Q000628:therapy; D008875:Middle Aged; D049268:Positron-Emission Tomography / Q000379:methods; D018570:Risk Assessment; D014019:Tissue Donors; D014057:Tomography, X-Ray Computed / Q000379:methods; D014181:Transplantation Immunology; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents