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Successful treatment of a classic Hodgkin lymphoma‐type post‐transplant lymphoproliferative disorder with tailored chemotherapy and Epstein–Barr virus‐specific cytotoxic T lymphocytes in a pediatric heart transplant recipient
Author(s) -
Basso Sabrina,
Zecca Marco,
Calafiore Lucia,
Rubert Laura,
Fiocchi Roberto,
Paulli Marco,
Quartuccio Giuseppe,
Guido Ilaria,
Sebastiani Roberta,
Croci Giorgio Alberto,
Beschi Claudia,
Nardiello Ida,
Ginevri Fabrizio,
Cugno Chiara,
Comoli Patrizia
Publication year - 2013
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1111/petr.12146
Subject(s) - medicine , immunosuppression , chemotherapy , post transplant lymphoproliferative disorder , lymphoma , lymphoproliferative disorders , discontinuation , epstein–barr virus , heart transplantation , immunology , oncology , transplantation , virus
CHL type is the least common major form of EBV ‐related PTLD but rarely occurs in pediatric recipients; development of CHL subsequent to other PTLD subtypes in the same transplant recipient is even more unusual. Because of its rarity, indications on the best treatment strategy are limited. Patients have been mostly treated with standard HL chemotherapy/radiotherapy, and prognosis seems more favorable than other monomorphic PTLD s. Herein, we describe a pediatric case of EBV ‐associated, stage IV ‐B, CHL arising in a heart allograft recipient eight yr after diagnosis of B‐cell polymorphic PTLD . The patient was successfully treated with adjusted‐dose HL chemotherapy and autologous EBV ‐specific CTL, without discontinuation of maintenance immunosuppression. At two yr from therapy completion, the patient is in CR with stable organ function. With this strategy, it may be possible to reproduce the good prognostic data reported for CHL ‐type PTLD , with decreased risk of organ toxicity or rejection.