Abstract
Post-transplant lymphoproliferative disorder (PTLD) is a complication of allogeneic bone marrow transplantation (BMT). Rare cases of PTLD after autologous BMT have been reported only in adults. This case report is the first to describe PTLD in a pediatric patient after autologous peripheral stem cell transplantation (PSCT). This 2-year-old male with stage IV neuroblastoma underwent autologous PSCT. The post-PSCT course was complicated by fever with hematochezia and a lung mass. On day 94 post PSCT, colonoscopy revealed an ulcer due to a PTLD, monomorphic type, B cell phenotype, associated with Epstein-Barr virus. Fine needle aspiration identified the lung mass as neuroblastoma. PTLD can occur in pediatric autologous PSCT recipients, and may occur more frequently in autologous grafts manipulated by T cell depletion or CD34+ cell selection.
MeSH terms
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Adrenal Gland Neoplasms / drug therapy
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Adrenal Gland Neoplasms / surgery
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Adrenal Gland Neoplasms / therapy*
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Adrenalectomy
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Antineoplastic Combined Chemotherapy Protocols / therapeutic use
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Child, Preschool
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Cisplatin / administration & dosage
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Colonic Diseases / etiology
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Colonic Diseases / virology
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Combined Modality Therapy
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Cyclophosphamide / administration & dosage
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Cytomegalovirus Infections / etiology
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Doxorubicin / administration & dosage
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Duodenal Ulcer / etiology
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Duodenal Ulcer / virology
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Epstein-Barr Virus Infections / complications
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Etoposide / administration & dosage
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Gastrointestinal Hemorrhage / etiology
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Hematopoietic Stem Cell Transplantation*
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Humans
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Immunocompromised Host
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Immunosuppressive Agents / adverse effects*
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Lung Neoplasms / secondary
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Lymphatic Metastasis
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Lymphoma, Large B-Cell, Diffuse / etiology*
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Lymphoma, Large B-Cell, Diffuse / pathology
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Lymphoma, Large B-Cell, Diffuse / virology
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Male
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Neuroblastoma / drug therapy
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Neuroblastoma / secondary
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Neuroblastoma / surgery
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Neuroblastoma / therapy*
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Orbital Neoplasms / secondary
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Prion Diseases
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Transplantation Conditioning / adverse effects*
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Transplantation, Autologous
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Ulcer / etiology
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Ulcer / virology
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Vincristine / administration & dosage
Substances
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Immunosuppressive Agents
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Vincristine
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Etoposide
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Doxorubicin
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Cyclophosphamide
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Cisplatin