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Lymphoproliferative disorder post renal transplantation: Recent experience at a single centre
Author(s) -
PEDAGOGOS Eugenia,
DOWLING John,
ROCKMAN Steven,
NICHOLLS Kathy,
FRASER Ian,
WALKER Rowan
Publication year - 1996
Publication title -
nephrology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.752
H-Index - 61
eISSN - 1440-1797
pISSN - 1320-5358
DOI - 10.1111/j.1440-1797.1996.tb00076.x
Subject(s) - medicine , prednisolone , azathioprine , transplantation , lymphoproliferative disorders , ganciclovir , cytomegalovirus , post transplant lymphoproliferative disorder , monoclonal , epstein–barr virus , lymphoma , gastroenterology , immunology , pathology , herpesviridae , disease , virus , viral disease , human cytomegalovirus , monoclonal antibody , antibody
Summary: Post‐transplant lymphoproliferative disorder was diagnosed in six renal transplant recipients at the Royal Melbourne Hospital over a 5 year period to December 1994. This constituted a detection rate of 2.2%. All patients were treated with cyclosporine, azathioprine, prednisolone and orthoclone (OKT3). the median time of onset was 2 months (range 0.3 months‐3 years) after transplant. Two patients who ultimately died presented with the diffuse form of the disease where immunoblasts massively infiltrated all organs. These tumours were monoclonal B cell lymphomas and Epstein‐Barr virus (EBV) reactivation could be demonstrated. One patient developed a polyclonal B cell tumour with primary EBV infection and the remaining 3 patients tresented with T cell polyclonal proliferations and were EBV negative. No cytomegalovirus (CMV) infections, primary or reactionary were observed. Therapy in all cases consisted of reducing or ceasing immunosuppressive treatment and in three patients ganciclovir was used. Four polyclonal tumours responded to the treatment measures.