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Published in: Medical Oncology 3/2011

01-09-2011 | Original Paper

Post-transplantation lymphoproliferative disorder (PTLD) twenty years after heart transplantation: a case report and review of the literature

Author: Petros D. Grivas

Published in: Medical Oncology | Issue 3/2011

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Abstract

We report a 62-year-old man who developed biopsy-proven post-transplantation lymphoproliferative disorder (PTLD) 20 years after receiving a heart transplant while being treated with immunosuppressive agents. The patient presented with large retroperitoneal and intestinal wall masses that caused partial gastrointestinal stenosis. Monoclonal antibody against CD20 in conjunction with chemotherapy and tapering of the immunosuppressive regimen was instituted, resulting in objective response of the disease bulk. To the best of our knowledge, this is the second reported case of PTLD 20 years after heart transplantation.
Literature
1.
go back to reference Yamani MH, Taylor DO, Haire C, Smedira N, Starling RC. Post-transplant ischemic injury is associated with up-regulated AlloMap gene expression. Clin Transplant. 2007;21:523–5.PubMedCrossRef Yamani MH, Taylor DO, Haire C, Smedira N, Starling RC. Post-transplant ischemic injury is associated with up-regulated AlloMap gene expression. Clin Transplant. 2007;21:523–5.PubMedCrossRef
2.
go back to reference Roithmaier S, et al. Incidence of malignancies in heart and/or lung transplant recipients: a single-institution experience. J Heart Lung Transplant. 2007;26:845–9.PubMedCrossRef Roithmaier S, et al. Incidence of malignancies in heart and/or lung transplant recipients: a single-institution experience. J Heart Lung Transplant. 2007;26:845–9.PubMedCrossRef
3.
go back to reference Leblond V, et al. Identification of prognostic factors in 61 patients with posttransplantation lymphoproliferative disorders. J Clin Oncol. 2001;19:772–8.PubMed Leblond V, et al. Identification of prognostic factors in 61 patients with posttransplantation lymphoproliferative disorders. J Clin Oncol. 2001;19:772–8.PubMed
4.
go back to reference Ghobrial IM, et al. Prognostic analysis for survival in adult solid organ transplant recipients with post-transplantation lymphoproliferative disorders. J Clin Oncol. 2005;23:7574–82.PubMedCrossRef Ghobrial IM, et al. Prognostic analysis for survival in adult solid organ transplant recipients with post-transplantation lymphoproliferative disorders. J Clin Oncol. 2005;23:7574–82.PubMedCrossRef
5.
go back to reference Choquet S, Levy V, Leblond V. Identification of prognostic factors in post-transplantation lymphoproliferative disorders. Bull Cancer. 2004;91:373–8.PubMed Choquet S, Levy V, Leblond V. Identification of prognostic factors in post-transplantation lymphoproliferative disorders. Bull Cancer. 2004;91:373–8.PubMed
6.
go back to reference Tsai DE, et al. Reduction in immunosuppression as initial therapy for posttransplant lymphoproliferative disorder: analysis of prognostic variables and long-term follow-up of 42 adult patients. Transplantation. 2001;71:1076–88.PubMedCrossRef Tsai DE, et al. Reduction in immunosuppression as initial therapy for posttransplant lymphoproliferative disorder: analysis of prognostic variables and long-term follow-up of 42 adult patients. Transplantation. 2001;71:1076–88.PubMedCrossRef
7.
8.
go back to reference Schubert S, et al. Relationship of immunosuppression to Epstein-Barr viral load and lymphoproliferative disease in pediatric heart transplant patients. J Heart Lung Transplant. 2008;27(1):100–5.PubMedCrossRef Schubert S, et al. Relationship of immunosuppression to Epstein-Barr viral load and lymphoproliferative disease in pediatric heart transplant patients. J Heart Lung Transplant. 2008;27(1):100–5.PubMedCrossRef
9.
go back to reference Preiksaitis JK, Keay S. Diagnosis and management of posttransplant lymphoproliferative disorder in solid-organ transplant recipients. Clin Infect Dis. 2001;33(Suppl 1):S38–46.PubMedCrossRef Preiksaitis JK, Keay S. Diagnosis and management of posttransplant lymphoproliferative disorder in solid-organ transplant recipients. Clin Infect Dis. 2001;33(Suppl 1):S38–46.PubMedCrossRef
10.
go back to reference Wasson S, Zafar MN, Best J, Reddy HK. Post-transplantation lymphoproliferative disorder in heart and kidney transplant patients: a single-center experience. J Cardiovasc Pharmacol Ther. 2006;11(1):77–83.PubMedCrossRef Wasson S, Zafar MN, Best J, Reddy HK. Post-transplantation lymphoproliferative disorder in heart and kidney transplant patients: a single-center experience. J Cardiovasc Pharmacol Ther. 2006;11(1):77–83.PubMedCrossRef
11.
go back to reference Swinnen LJ, Fischer RI. OKT3 monoclonal antibodies induce interleukin-6 and interleukin-10: a possible cause of lymphoproliferative disorders associated with transplantation. Curr Opin Nephrol Hypertens. 1993;2:670–8.PubMed Swinnen LJ, Fischer RI. OKT3 monoclonal antibodies induce interleukin-6 and interleukin-10: a possible cause of lymphoproliferative disorders associated with transplantation. Curr Opin Nephrol Hypertens. 1993;2:670–8.PubMed
12.
go back to reference Opel ZG, Dohler G. Lymphomas after solid organ transplantation: a collaborative transplant study report. Am J Transplant. 2004;4:222–30.CrossRef Opel ZG, Dohler G. Lymphomas after solid organ transplantation: a collaborative transplant study report. Am J Transplant. 2004;4:222–30.CrossRef
13.
go back to reference Keever-Taylor CA, et al. Complement-mediated T-cell depletion of bone marrow: comparison of T10B9. 1A–31 and Muromonab-Orthoclone OKT3. Cytotherapy. 2001;3(6):467–81.PubMedCrossRef Keever-Taylor CA, et al. Complement-mediated T-cell depletion of bone marrow: comparison of T10B9. 1A–31 and Muromonab-Orthoclone OKT3. Cytotherapy. 2001;3(6):467–81.PubMedCrossRef
14.
go back to reference Ciancio G, et al. Post-transplant lymphoproliferative disease in kidney transplant patients in the new immunosuppressive era. Clin Transplant. 1997;11(3):243–9.PubMed Ciancio G, et al. Post-transplant lymphoproliferative disease in kidney transplant patients in the new immunosuppressive era. Clin Transplant. 1997;11(3):243–9.PubMed
16.
go back to reference Schulz TF. Cancer and viral infections in immunocompromised individuals. Int J Cancer. 2009;125(8):1755–63.PubMedCrossRef Schulz TF. Cancer and viral infections in immunocompromised individuals. Int J Cancer. 2009;125(8):1755–63.PubMedCrossRef
17.
go back to reference Yates J, Warren N, Reisman D, Sugden B. A cis-acting element from the Epstein-Barr viral genome that permits stable replication of recombinant plasmids in latently infected cells. Proc Natl Acad Sci U S A. 1984;81:3806–10.PubMedCrossRef Yates J, Warren N, Reisman D, Sugden B. A cis-acting element from the Epstein-Barr viral genome that permits stable replication of recombinant plasmids in latently infected cells. Proc Natl Acad Sci U S A. 1984;81:3806–10.PubMedCrossRef
18.
go back to reference Johannsen E, et al. Epstein-Barr virus nuclear protein 2 transactivation of the latent membrane protein 1 promoter is mediated by J kappa and PU. 1. J Virol. 1995;69:253–62.PubMed Johannsen E, et al. Epstein-Barr virus nuclear protein 2 transactivation of the latent membrane protein 1 promoter is mediated by J kappa and PU. 1. J Virol. 1995;69:253–62.PubMed
19.
go back to reference Wang F, et al. Epstein-Barr virus latent membrane protein (LMP1) and nuclear proteins 2 and 3C are effectors of phenotypic changes in B lymphocytes: EBNA-2 and LMP1 cooperatively induce CD23. J Virol. 1990;64:2309–18.PubMed Wang F, et al. Epstein-Barr virus latent membrane protein (LMP1) and nuclear proteins 2 and 3C are effectors of phenotypic changes in B lymphocytes: EBNA-2 and LMP1 cooperatively induce CD23. J Virol. 1990;64:2309–18.PubMed
20.
go back to reference Capello D, Rossi D, Gaidano G. Post-transplant lymphoproliferative disorders: molecular basis of disease histogenesis and pathogenesis. Hematol Oncol. 2005;23:61–7.PubMedCrossRef Capello D, Rossi D, Gaidano G. Post-transplant lymphoproliferative disorders: molecular basis of disease histogenesis and pathogenesis. Hematol Oncol. 2005;23:61–7.PubMedCrossRef
21.
go back to reference Bräuninger A, et al. Epstein-Barr virus (EBV)-positive lymphoproliferations in post-transplant patients show immunoglobulin V gene mutation patterns suggesting interference of EBV with normal B cell differentiation processes. Eur J Immunol. 2003;33:1593–602.PubMedCrossRef Bräuninger A, et al. Epstein-Barr virus (EBV)-positive lymphoproliferations in post-transplant patients show immunoglobulin V gene mutation patterns suggesting interference of EBV with normal B cell differentiation processes. Eur J Immunol. 2003;33:1593–602.PubMedCrossRef
22.
go back to reference Mosialos G, et al. The Epstein-Barr virus transforming protein LMP1 engages signaling proteins for the tumor necrosis factor receptor family. Cell. 1995;80:389–99.PubMedCrossRef Mosialos G, et al. The Epstein-Barr virus transforming protein LMP1 engages signaling proteins for the tumor necrosis factor receptor family. Cell. 1995;80:389–99.PubMedCrossRef
23.
go back to reference Capello D, Berra E, Cerri M, Gaidano G. Post-transplant lymphoproliferative disorders. Molecular analysis of histogenesis and pathogenesis. Minerva Med. 2004;95:53–64.PubMed Capello D, Berra E, Cerri M, Gaidano G. Post-transplant lymphoproliferative disorders. Molecular analysis of histogenesis and pathogenesis. Minerva Med. 2004;95:53–64.PubMed
24.
go back to reference Novoa-Takara L, et al. Histogenetic phenotypes of B cells in posttransplant lymphoproliferative disorders by immunohistochemical analysis correlate with transplant type: solid organ vs hematopoietic stem cell transplantation. Am J Clin Pathol. 2005;123:104–12.PubMedCrossRef Novoa-Takara L, et al. Histogenetic phenotypes of B cells in posttransplant lymphoproliferative disorders by immunohistochemical analysis correlate with transplant type: solid organ vs hematopoietic stem cell transplantation. Am J Clin Pathol. 2005;123:104–12.PubMedCrossRef
25.
go back to reference Paya CV, et al. Epstein-Barr virus-induced posttransplant lymphoproliferative disorders. ASTS/ASTP EBV-PTLD task force and the mayo clinic organized international consensus development meeting. Transplantation. 1999;68:1517–25.PubMedCrossRef Paya CV, et al. Epstein-Barr virus-induced posttransplant lymphoproliferative disorders. ASTS/ASTP EBV-PTLD task force and the mayo clinic organized international consensus development meeting. Transplantation. 1999;68:1517–25.PubMedCrossRef
26.
go back to reference Green M, Reyes J, Webber S, Rowe D. The role of antiviral and immunoglobulin therapy in the prevention of Epstein-Barr virus infection and post-transplant lymphoproliferative disease following solid organ transplantation. Transpl Infect Dis. 2001;3:97–103.PubMedCrossRef Green M, Reyes J, Webber S, Rowe D. The role of antiviral and immunoglobulin therapy in the prevention of Epstein-Barr virus infection and post-transplant lymphoproliferative disease following solid organ transplantation. Transpl Infect Dis. 2001;3:97–103.PubMedCrossRef
27.
go back to reference Middeldorp JM, Brink AA, van den Brule AJ, Meijer CJ. Pathogenic roles for Epstein-Barr virus (EBV) gene products in EBV-associated proliferative disorders. Crit Rev Oncol Hematol. 2003;45(1):1–36.PubMedCrossRef Middeldorp JM, Brink AA, van den Brule AJ, Meijer CJ. Pathogenic roles for Epstein-Barr virus (EBV) gene products in EBV-associated proliferative disorders. Crit Rev Oncol Hematol. 2003;45(1):1–36.PubMedCrossRef
28.
go back to reference Davis CL, et al. Interferon-alpha treatment in post-transplant lymphoproliferative disorder in recipients of solid organ transplants. Transplantation. 1998;66:1770–9.PubMedCrossRef Davis CL, et al. Interferon-alpha treatment in post-transplant lymphoproliferative disorder in recipients of solid organ transplants. Transplantation. 1998;66:1770–9.PubMedCrossRef
29.
go back to reference Choquel S, et al. Efficacy and safety of rituximab in B-cell post-transplantation lymphoproliferative disorders: results of a prospective multicenter phase 2 study. Blood. 2006;107:3053–7.CrossRef Choquel S, et al. Efficacy and safety of rituximab in B-cell post-transplantation lymphoproliferative disorders: results of a prospective multicenter phase 2 study. Blood. 2006;107:3053–7.CrossRef
30.
go back to reference Choquet S, et al. Rituximab in the management of post-transplantation lymphoproliferative disorder after solid organ transplantation: proceed with caution. Ann Hematol. 2007;86:599–607.PubMedCrossRef Choquet S, et al. Rituximab in the management of post-transplantation lymphoproliferative disorder after solid organ transplantation: proceed with caution. Ann Hematol. 2007;86:599–607.PubMedCrossRef
31.
go back to reference Hande KR, Garrow GC. Acute tumor lysis syndrome in patients with high-grade non-Hodgkin’s lymphoma. Am J Med. 1993;94(2):133–9.PubMedCrossRef Hande KR, Garrow GC. Acute tumor lysis syndrome in patients with high-grade non-Hodgkin’s lymphoma. Am J Med. 1993;94(2):133–9.PubMedCrossRef
32.
go back to reference Montesinos P, et al. Tumor lysis syndrome in patients with acute myeloid leukemia: identification of risk factors and development of a predictive model. Haematologica. 2008;93(1):67–74.PubMedCrossRef Montesinos P, et al. Tumor lysis syndrome in patients with acute myeloid leukemia: identification of risk factors and development of a predictive model. Haematologica. 2008;93(1):67–74.PubMedCrossRef
33.
go back to reference Alavi S, Arzanian MT, Abbasian MR, Ashena Z. Tumor lysis syndrome in children with non-Hodgkin lymphoma. Pediatr Hematol Oncol. 2006;23(1):65–70.PubMedCrossRef Alavi S, Arzanian MT, Abbasian MR, Ashena Z. Tumor lysis syndrome in children with non-Hodgkin lymphoma. Pediatr Hematol Oncol. 2006;23(1):65–70.PubMedCrossRef
34.
go back to reference Kaleem Z, Hassan A, Pathan MH, White G. Flow cytometric evaluation of posttransplant B-cell lymphoproliferative disorders. Arch Pathol Lab Med. 2004;128:181–6.PubMed Kaleem Z, Hassan A, Pathan MH, White G. Flow cytometric evaluation of posttransplant B-cell lymphoproliferative disorders. Arch Pathol Lab Med. 2004;128:181–6.PubMed
35.
go back to reference Buadi FK, et al. Treatment and outcomes of post-transplant lymphoproliferative disease: a single institution study. Am J Hematol. 2007;82(3):208–14.PubMedCrossRef Buadi FK, et al. Treatment and outcomes of post-transplant lymphoproliferative disease: a single institution study. Am J Hematol. 2007;82(3):208–14.PubMedCrossRef
Metadata
Title
Post-transplantation lymphoproliferative disorder (PTLD) twenty years after heart transplantation: a case report and review of the literature
Author
Petros D. Grivas
Publication date
01-09-2011
Publisher
Springer US
Published in
Medical Oncology / Issue 3/2011
Print ISSN: 1357-0560
Electronic ISSN: 1559-131X
DOI
https://doi.org/10.1007/s12032-010-9523-2

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