Post-transplantation lymphoproliferative disorders localizing to the gastrointestinal tract after liver transplantation: Report of five pediatric cases
Journal
Pediatric Transplantation
Journal Volume
10
Journal Issue
3
Pages
390-394
Date Issued
2006
Abstract
Post-transplantation lymphoproliferative disorder (PTLD) is a life-threatening complication of organ transplantation. PTLD can occur in every kind of organ transplantation. From July 1992 to July 2004, five patients were diagnosed at our transplantation center with PTLD after pediatric liver transplantation. During this period, there were 52 pediatric patients (<18 yr) receiving an orthotopic liver transplantation (OLT) at our center. All five patients had transmural gastrointestinal (GI) PTLD, which occurred mostly in the stomach and duodenum. Epstein-Barr virus (EBV) in situ was demonstrated in each case. EBV viral load was noted to be an important risk factor. Treatment included dose reduction of immunosuppressants and anti-CD20 antibody infusion. Chemotherapy, including cyclophosphamide, doxorubicin, vincristine, and prednisolone, was given to three patients. Four patients have survived more than 10 months until now after treatment. The one who was unresponsive to chemotherapy and anti-CD20 antibody had diffuse metastasis and died of systemic candidiasis. In our series, each PTLD involved the GI tract. The mechanism of this phenomenon is unclear, but these five cases indicate the high incidence of PTLD in pediatric solid organ transplantation. ? 2006 Blackwell Munksgaard.
SDGs
Other Subjects
CD20 antibody; cyclophosphamide; cyclosporin; doxorubicin; methylprednisolone; prednisolone; tacrolimus; vincristine; article; B cell lymphoma; cancer combination chemotherapy; cancer mortality; child; clinical article; drug dose reduction; drug withdrawal; duodenum tumor; Epstein Barr virus; female; gastrointestinal tumor; human; human tissue; immunosuppressive treatment; liver transplantation; lymphoproliferative disease; male; posttransplant lymphoproliferative disease; risk factor; stomach tumor; survival; virus infection; virus load; Antigens, CD20; Child, Preschool; Duodenum; Epstein-Barr Virus Infections; Female; Gastrointestinal Diseases; Herpesvirus 4, Human; Humans; Immunosuppressive Agents; Infant; Liver Transplantation; Lymphoproliferative Disorders; Male; Stomach
Type
journal article