Successful treatment of post-transplant lymphoproliferative disorder in autologous blood stem cell transplant recipients

Bone Marrow Transplant. 2002 Sep;30(5):321-6. doi: 10.1038/sj.bmt.1703603.

Abstract

We report three cases of post-transplant lymphoproliferative disorder (PTLD) in the context of autologous stem cell transplantation (ASCT) for multiple myeloma (MM) and non-Hodgkin's lymphoma. The first two cases received ASCT for MM, one with a CD34-selected autograft and the other with an unmanipulated autograft. Both these cases of PTLD achieved a complete response following treatment with IVIG, gancyclovir, solumedrol and interferon (IFN). The third case received ASCT with an unmanipulated autograft for relapsed angioimmunoblastic lymphoma. He also achieved a complete response but only after rituximab was added to IVIG, gancyclovir, solumedrol and IFN. None of these patients experienced a relapse of their PTLD with follow-up ranging from 1.5 to 5 years. These cases highlight the importance of considering PTLD in the differential diagnosis of lymphadenopathy and fever post ASCT. They also demonstrate the possibility of durable complete remission of post-ASCT PTLD following antiviral and immune modulating therapy.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antineoplastic Agents / administration & dosage
  • Antiviral Agents / administration & dosage
  • Diagnosis, Differential
  • Humans
  • Immunoblastic Lymphadenopathy / complications
  • Immunoblastic Lymphadenopathy / therapy
  • Immunotherapy
  • Lymphoma, Non-Hodgkin / complications
  • Lymphoma, Non-Hodgkin / therapy
  • Lymphoproliferative Disorders / diagnosis
  • Lymphoproliferative Disorders / drug therapy*
  • Lymphoproliferative Disorders / etiology
  • Male
  • Middle Aged
  • Multiple Myeloma / complications
  • Multiple Myeloma / therapy
  • Peripheral Blood Stem Cell Transplantation / adverse effects*
  • Remission Induction / methods
  • Transplantation, Autologous / adverse effects

Substances

  • Antineoplastic Agents
  • Antiviral Agents