Classical Hodgkin lymphoma-type PTLD after solid organ transplantation in children: a report on 17 patients treated according to subsequent GPOH-HD treatment schedules.
Post-transplant lymphoproliferative disease (PTLD) is a severe complication after solid organ transplantation (SOT). Classical Hodgkin lymphoma-type (HL-) PTLD is a rare subtype, and systematic data on treatment and prognosis are lacking. We report on 17 pediatric patients with classical HL-PTLD. HL-PTLD developed late at a median of 8.1 years after SOT. It was commonly EBV-positive (16/17) and expressed both CD30 (all tumors) and CD20 (8/17 tumors). Patients were treated with chemotherapy +/- involved field radiotherapy (IF-RT) according to the respective GPOH-HD protocol tailored by stage and LDH. Overall survival at 2 and 5 years was 86% with 81% of patients surviving event-free. Six patients had additional rituximab treatment; in two it was given as upfront monotherapy and in four was given concurrently with their chemotherapy. Rituximab monotherapy did not lead to long-term remission. In conclusion, treatment of HL-PTLD with classical HL chemotherapy is effective and tolerable. New treatment modalities such as CD30-targeted or EBV-specific agents may diminish toxicity.
a Department of Pediatric Hematology and Oncology , Hannover Medical School , Hannover , Germany.
Johanna
J
Kampers
b Pediatric Oncology Hematology & Stem Cell Transplantation , Columbia University Medical Center , New York , NY , USA.
Manuela
M
Orjuela-Grimm
a Department of Pediatric Hematology and Oncology , Hannover Medical School , Hannover , Germany.|c Dr. von Hauner Children's Hospital, Ludwig-Maximilians-Universität München , Munich , Germany.
Tilmann
T
Schober
d Institute of Virology , Hannover Medical School , Hannover , Germany.
Thomas F
TF
Schulz
e Center of Pediatrics, University of Halle/Saale , Halle , Germany.
Martina
M
Stiefel
c Dr. von Hauner Children's Hospital, Ludwig-Maximilians-Universität München , Munich , Germany.
Christoph
C
Klein
f Pediatric Hematology and Oncology, Department of Pediatrics , Justus Liebig University of Gießen , Gießen , Germany.
Dieter
D
Körholz
f Pediatric Hematology and Oncology, Department of Pediatrics , Justus Liebig University of Gießen , Gießen , Germany.|j Medical Faculty of the Martin-Luther-University Halle-Wittenberg , Halle , Germany.
Christine
C
Mauz-Körholz
g Institute of Pathology , Hannover Medical School , Hannover , Germany.
Hans
H
Kreipe
a Department of Pediatric Hematology and Oncology , Hannover Medical School , Hannover , Germany.|h Pediatric Hematology and Oncology, Department for Pediatrics III , University Hospital of Essen , Essen , Germany.
Rita
R
Beier
a Department of Pediatric Hematology and Oncology , Hannover Medical School , Hannover , Germany.|i Integrated Research and Treatment Center Transplantation (IFB-Tx) , Hannover , Germany.
Britta
B
Maecker-Kolhoff
D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D060830:Consolidation Chemotherapy; D005260:Female; D006689:Hodgkin Disease / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality / Q000628:therapy*; D006801:Humans; D008232:Lymphoproliferative Disorders / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality / Q000628:therapy*; D008297:Male; D009367:Neoplasm Staging; D016609:Neoplasms, Second Primary / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality / Q000628:therapy*; D016377:Organ Transplantation / Q000009:adverse effects*; D018714:Radiotherapy, Adjuvant; D012074:Remission Induction; D016896:Treatment Outcome; D055815:Young Adult
Hodgkin lymphoma; PTLD; pediatric; solid organ transplantation