Remission of Late-Onset Post-Liver Transplantation Non-Hodgkin Lymphoma

Pril (Makedon Akad Nauk Umet Odd Med Nauki). 2019 May 1;40(1):67-71. doi: 10.2478/prilozi-2019-0005.

Abstract

We describe the clinical course of a patient who developed high-grade lymphoma during immunosuppression treatment with cyclosporine A, following liver transplantation. After anti-neoplastic polychemotherapy treatment, the remission of lymphoma was confirmed and maintained for over four years. The patient, a 27 year old female had liver transplantation at the age of 17, due to acute liver failure, caused by non-diagnosed Wilson disease. Nearly seven years post-transplantation, the patient was diagnosed with non-Hodgkin B-cell lymphoma (NHBCL), potentially induced by Cephalosporin A therapy. After the treatment with rituximab and CHOP therapy (r-CHOP protocol), remission was determined using computer tomography. Remission is maintained to date. A review of reported cases of post-transplant lymphoproliferative disorders (PTLDs) in liver transplanted (LT) patients showed that the onset of PTLDs is the highest in the first year after transplantation. In addition, remission rates of NHBCL in LT patients are not much elaborated in the literature. It is our opinion that the presented case is rare, both from the aspect of timeline of occurrence of the PTLD and the achieved remission, using r-CHOP protocol.

Keywords: Non-Hodgkin; immunosuppression; liver; lymphoma; transplants.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antineoplastic Agents, Immunological / administration & dosage
  • Antineoplastic Agents, Immunological / therapeutic use
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Cyclophosphamide / administration & dosage
  • Cyclophosphamide / therapeutic use
  • Cyclosporine / adverse effects*
  • Doxorubicin / administration & dosage
  • Doxorubicin / therapeutic use
  • Female
  • Humans
  • Immunosuppressive Agents / adverse effects*
  • Liver Transplantation / adverse effects*
  • Lymphoma, Non-Hodgkin / chemically induced*
  • Lymphoma, Non-Hodgkin / drug therapy
  • Lymphoproliferative Disorders / chemically induced
  • Prednisone / administration & dosage
  • Prednisone / therapeutic use
  • Remission Induction
  • Rituximab / administration & dosage
  • Rituximab / therapeutic use
  • Vincristine / administration & dosage
  • Vincristine / therapeutic use

Substances

  • Antineoplastic Agents, Immunological
  • Immunosuppressive Agents
  • R-CHOP protocol
  • Rituximab
  • Vincristine
  • Doxorubicin
  • Cyclosporine
  • Cyclophosphamide
  • Prednisone