PTLD in a kidney receptor: case report
PDF (Español)
PDF

Supplementary Files

Sin título (Español)

Keywords

Epstein Barr Virus
kidney transplantation
rituximab
Lymphoproliferative disorders

How to Cite

1.
Rodríguez Sánchez MP, García Padilla PK, Contreras KM, González González CA, Puentes S. PTLD in a kidney receptor: case report. Rev. Colomb. Nefrol. [Internet]. 2017 Jul. 27 [cited 2024 Mar. 29];4(2):210-6. Available from: https://revistanefrologia.org/index.php/rcn/article/view/218

Abstract

Posttransplant Lymphoproliferative Disorders (PTLDs) occur in 3 to 10% of adults with solid organ transplant (SOT). It has been associated with Epstein Barr Virus (EBV) infection. Differential diagnostics of PTLD from rejection or viral infection is difficult when the tumor infiltrates the graft, because the clinical and histopathological findings are similar. We report a case of patient with chronic kidney disease due to Ig M glomerulonephritis with cadaveric donor kidney transplantation who presented proteinuria and decreased glomerular filtration rate, with a solid mass at renal graft and confirmatory histology of polymorphic renal transplant lymphoproliferative disorder (PTLD), VEB positive, and CD 20 positive. The patient was treated with rituximab 375 mg / m2 weekly, four doses, followed by chemotherapy with ciclophosphamide, vincristine and doxorubicin. He didn’t need radiotherapy or graft nephrectomy, with complete remission at one year of follow-up and optimal graft function.

https://doi.org/10.22265/acnef.4.2.218
PDF (Español)
PDF

References

1. Jagadeesh D, Woda BA, Draper J, Evens AM. Post transplant lymphoproliferative disorders: Risk, classification, and therapeutic recommendations. Curr Treat Options Oncol. 2012;13(1):122-36. Disponible en: https:doi.org/10.1007/s11864-011-0177-x

2. Caillard S, Lamy FX, Quelen C, et al. Epidemiology of posttransplant lymphoproliferative disorders in adult kidney and kidney pancreas recipients: Report of the French registry and analysis of subgroups of lymphomas. Am J Transplant. 2012;12(3):682-93. Disponible en: https://doi.org/10.1111/j.1600-6143.2011.03896.x

3. Petrara MR, Giunco S, Serraino D, Dolcetti R, De Rossi A. Post-transplant lymphoproliferative disorders: From epidemiology to pathogenesis-driven treatment. Cancer Lett. 2015;369(1):37-44. Disponible en: https://doi.org/10.1016/j.canlet.2015.08.007

4. Tse E, Kwong Y-L. Epstein Barr virus-associated lymphoproliferative diseases: the virus as a therapeutic target. Exp Mol Med. 2015;47(1):e136. Disponible en: https://doi.org/10.1038/emm.2014.102

5. Yoon J-H, Lee S, Kim H-J, et al. Comparative analysis of post-transplant lymphoproliferative disorder after kidney transplantation versus hematopoietic stem cell transplantation. Transpl Int. 2014;27(7):721-32. Disponible en: https://doi.org/10.1111/tri.12328

6. Taylor AL, Marcus R, Bradley JA. Post-transplant lymphoproliferative disorders (PTLD) after solid organ transplantation. Crit Rev Oncol Hematol. 2005;56(1 Spec No):155-67. doi:10.1016/j.critrevonc.2005.03.015

7. Morton M, Coupes B, Roberts SA, et al. Epidemiology of posttransplantation lymphoproliferative disorder in adult renal transplant recipients. Transplantation. 2013;95(3):470-8. Disponible en: https://doi.org/10.1097/TP.0b013e318276a237

8. Jha B, Mohan N, Gajendra S, et al. Prompt diagnosis and management of Epstein-Barr virus-associated post-transplant lymphoproliferative disorder and hemophagocytosis: A dreaded complication in a post-liver transplant child. Pediatr Transplant. 2015;19(7):E177-80. Disponible en: https://doi.org/10.1111/petr.12558

9. Dierickx D, Tousseyn T, Gheysens O. How I treat posttransplant lymphoproliferative disorders. Blood. 2015;126(20):2274-83. https://doi.org/10.1182/blood-2015-05-615872

10. Singavi AK, Harrington AM, Fenske TS. Post-transplant lymphoproliferative disorders. Cancer Treat Res. 2015;165:305-27. https://doi.org/10.1007/978-3-319-13150-4_13

11. Foran JM, Norton AJ, Micallef INM, et al. Loss of CD20 expression following treatment with rituximab (chimaeric monoclonal anti-CD20): A retrospective cohort analysis. Br J Haematol. 2001;114(4):881-3. Disponible en: https://doi.org/10.1046/j.1365-2141.2001.03019.x

12. Parker A, Bowles K, Bradley JA, et al. Management of post-transplant lymphoproliferative disorder in adult solid organ transplant recipients - BCSH and BTS Guidelines. Br J Haematol. 2010;149(5):693-705. Disponible en: https://doi.org/10.1111/j.1365-2141.2010.08160.x

13. Birkeland S a, Andersen HK, Hamilton-Dutoit SJ. Preventing acute rejection, Epstein-Barr virus infection, and posttransplant lymphoproliferative disorders after kidney transplantation: use of aciclovir and mycophenolate mofetil in a steroid-free immunosuppressive
protocol. Transplantation. 1999;67(9):1209-14. https://doi.org/10.109700007890-199905150-00002

14. Caillard S, Dharnidharka V, Agodoa L, Bohen E, Abbott K. Posttransplant lymphoproliferative disorders after renal transplantation in the United States in era of modern immunosuppression. Transplantation. 2005;80(9):1233-43. Disponible en: https://doi.org/10.1097/01.tp.0000179639.98338.39

15. Elstrom RL, Andreadis C, Aqui NA, et al. Treatment of PTLD with rituximab or chemotherapy. Am J Transplant. 2006;6(3):569-76. Disponible en: https://doi.org/10.1111/j.1600-6143.2005.01211.x

16. Tsai DE, Hardy CL, Tomaszewski JE, et al. Reduction in immunosuppression as initial therapy for posttransplant lymphoproliferative disorder: analysis of prognostic variables and longerm follow-up of 42 adult patients. Transplantation. 2001;71(8):1076-88. Disponible en: https://doi.org/10.109700007890-200104270-00012

17. Buell JF, Gross TG, Hanaway MJ, et al. Chemotherapy for posttransplant lymphoproliferative disorder: The Israel Penn International Transplant Tumor Registry Experience. Transplantation Proceedings. 2005;37(2):956-7. Disponible en: https://doi.org/10.1016/j.transproceed.2004.12.124
No national or foreign publication may partially or totally reproduce or translate Revista Colombiana de Nefrología articles or abstracts without prior written permission from the journal’s Editorial Board.

Dimensions


PlumX


Downloads

Download data is not yet available.