Role of Chemotherapy and Rituximab for Treatment of Posttransplant Lymphoproliferative Disorder in Solid Organ Transplantation

2007 ◽  
Vol 41 (10) ◽  
pp. 1648-1659 ◽  
Author(s):  
Jin-Joo Lee ◽  
Masha SH Lam ◽  
Amy Rosenberg
Keyword(s):  
Organ Transplantation ◽  
Lymphoproliferative Disorder ◽  
Disease Onset ◽  
Solid Organ Transplantation ◽  
Response Rates ◽  
Data Sources ◽  
Solid Organ ◽  
Posttransplant Lymphoproliferative Disorder ◽  
Early Disease

Objective: To evaluate the role of chemotherapy and/or rituximab for treatment of posttransplant lymphoproliferative disorder (PTLD) in solid organ transplantation. Data Sources: A MEDLINE search (1966–May 2007) was conducted using the key words posttransplant lymphoproliferative disorder, solid organ transplantation, chemotherapy, and rituximab. References of relevant articles and abstracts from recent hematology, oncology, and transplantation scientific meetings (2004–May 2007) were also reviewed. Study Selection and Data Extraction: Prospective and retrospective studies identified from the data sources were evaluated, and all information deemed relevant was included for this review. Data Synthesis: Overall response rates ranged from 53% to 68%, 25% to 83%, and 74% to 100% for rituximab monotherapy, chemotherapy, and chemotherapy plus rituximab, respectively. Positive response to treatment was influenced by prognostic factors, including presence of Epstein-Barr virus in tumor cells, normal lactate dehydrogenase levels, good performance status, early disease onset after transplantation, and early disease stages. These factors in study patients likely contribute to the variability in response rates seen between treatment options. Severe adverse effects, ranging from grade 3 neutropenia to infection resulting in death, occurred more frequently in patients receiving chemotherapy than in patients receiving only rituximab. Conclusions: Although reduction in immunosuppressive medications remains the first-line therapy for PTLD treatment, many cases do not respond to this treatment alone, especially monomorphic or more aggressive cases of lymphoma. Therefore, it is reasonable to begin active treatment including rituximab and/or chemotherapy initially, along with reduction in immunosuppression in many cases. Further prospective, comparative studies are urgently needed to confirm the efficacy of these treatment strategies as well as to clarify which subset of patients may benefit most from them.

scholarly journals Posttransplant Lymphoproliferative Disorder involving the Larynx

2016 ◽  
Vol 7 (1) ◽  
pp. 53-56 ◽  
Author(s):  
Nikita Kohli ◽  
Jared M Wasserman
Keyword(s):  
Differential Diagnosis ◽  
Organ Transplantation ◽  
Lymphoproliferative Disorder ◽  
Solid Organ Transplantation ◽  
Solid Organ ◽  
Posttransplant Lymphoproliferative Disorder ◽  
Waldeyer’S Ring ◽  
Acute Airway Obstruction ◽  
History Of ◽  
The Right

ABSTRACT Aim: Our goal is to present an unusual case of posttransplant lymphoproliferative disorder (PTLD) involving the larynx. We aim to expand the literature regarding head and neck manifestations involving PTLD and for otolaryngologists to include PTLD in their differential diagnosis of laryngeal lesions in patients who have a history of solid organ transplantation. Background Posttransplant lymphoproliferative disorder occurs in immunocompromised patients following solid organ transplantation. Head and neck manifestations most commonly involve Waldeyer's ring with the larynx and trachea being relatively uncommon sites of disease. However, lesions of the larynx can cause acute airway obstruction and rare fatalities have been reported in the literature. Case report We present the case of a 51-year-old female with a history of renal transplantation, who presented to the office after an incidental supraglottic lesion was discovered during intubation for cochlear implant placement. A mucosalized lesion arising from the right aryepiglottic fold with dynamic obstruction of the airway was noted on office endoscopic examination. Imaging revealed extension of the mass into the right posterolateral hypopharynx. The patient was taken to the operating room for microdirect laryngoscopy and CO2 laser excision of the mass. The lesion was excised with negative gross margins. Final pathology revealed plasmacytoma-like PTLD and the patient was referred back to her transplant team for modulation of her immunosuppressive therapy. Conclusion We present the case of an incidental supraglottic lesion in a posttransplant patient. Special emphasis should be given to the tissues of Waldeyer's ring and larynx. Clinical significance Posttransplant lymphoproliferative disorder, while rare, should be kept in the differential diagnosis of pharyngeal and airway lesions in patients with a history of solid organ transplantation. Expansile lesions can cause acute airway obstruction. Urgent evaluation and treatment of theses lesions is necessary in these circumstances. How to cite this article Kohli N, Wasserman JM. Posttransplant Lymphoproliferative Disorder involving the Larynx. Int J Head Neck Surg 2016;7(1):53-56.

scholarly journals Expression of PD-1, PD-L1, and PD-L2 in posttransplant lymphoproliferative disorder after solid organ transplantation

2018 ◽  
Vol 60 (2) ◽  
pp. 376-384 ◽  
Author(s):  
Amelie Kinch ◽  
Christer Sundström ◽  
Eva Baecklund ◽  
Carin Backlin ◽  
Daniel Molin ◽  
...  
Keyword(s):  
Organ Transplantation ◽  
Lymphoproliferative Disorder ◽  
Solid Organ Transplantation ◽  
Solid Organ ◽  
Posttransplant Lymphoproliferative Disorder

The role of radiotherapy in patients with solid tumours after solid organ transplantation: a systematic review

2021 ◽  
Vol 22 (3) ◽  
pp. e93-e104
Author(s):  
Rosario Mazzola ◽  
Francesco Cuccia ◽  
Alessandro Bertani ◽  
Slavisa Tubin ◽  
Pier Giulio Conaldi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Organ Transplantation ◽  
Solid Organ Transplantation ◽  
Solid Tumours ◽  
Solid Organ

Rituximab in the management of post-transplantation lymphoproliferative disorder after solid organ transplantation: proceed with caution

2007 ◽  
Vol 86 (8) ◽  
pp. 599-607 ◽  
Author(s):  
Sylvain Choquet ◽  
Stephan Oertel ◽  
Veronique LeBlond ◽  
Hanno Riess ◽  
Nathalie Varoqueaux ◽  
...  
Keyword(s):  
Organ Transplantation ◽  
Lymphoproliferative Disorder ◽  
Solid Organ Transplantation ◽  
Solid Organ ◽  
Post Transplantation
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