title: Rituximab, Dexamethasone, Cytarabine, and Cisplatin as Effective Platinum-Based Salvage Chemotherapy for Periportal Posttransplant Lymphoproliferative Disorder After an Orthotopic Liver Transplant.
abstract: Posttransplant lymphoproliferative disorder is a group of heterogenous disorders that occur after solid-organ transplant. The overall incidence is between 1% and 20%. In orthotopic liver transplant recipients, the reported incidence ranges from 2% to 10%, while the incidence is greater in children (9.7%-11%) and lesser in adults (1.7%-3%). The following treatment options are considered for patients with posttransplant lymphoproliferative disorder: reduction of immunosuppression, single-agent rituximab, rituximab and chemotherapy, surgery and radiation, antivirals targeted at the Epstein-Barr virus, and cytotoxic T-lymphocytes targeting the Epstein-Barr virus. This report describes a 61-year-old man who presented after an orthotopic liver transplant with a large periportal soft tissue mass that was shown on biopsy to be a monomorphic, CD20+, diffuse, large B-cell lymphoma, nongerminal center type. He was treated with reduced immunosuppression, followed by single-agent rituximab, then with an anthracycline-based chemotherapy regimen: rituximab, etoposide, prednisone, vincristine, doxorubicin, and then a platinum-based salvage chemotherapy with rituximab, dexamethasone, cytarabine, and cisplatin with a good response.
authors.affiliation: From the Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
authors.forename: Eliza W
authors.initials: EW
authors.lastname: Beal
authors.forename: Shaylyn
authors.initials: S
authors.lastname: Bennett
authors.forename: Latifa Sage
authors.initials: LS
authors.lastname: Silski
authors.forename: Bryan
authors.initials: B
authors.lastname: Whitson
authors.forename: Mitchell
authors.initials: M
authors.lastname: Henry
authors.forename: Sylvester
authors.initials: S
authors.lastname: Black
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001706:Biopsy; D002945:Cisplatin / Q000627:therapeutic use*; D003561:Cytarabine / Q000627:therapeutic use*; D003907:Dexamethasone / Q000627:therapeutic use*; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects; D016031:Liver Transplantation / Q000009:adverse effects*; D016403:Lymphoma, Large B-Cell, Diffuse / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography; D000069283:Rituximab / Q000627:therapeutic use*; D016879:Salvage Therapy; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D003561:Cytarabine; D000069283:Rituximab; D003907:Dexamethasone; D002945:Cisplatin