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Treatment of post‐transplant lymphoproliferative disorder (PTLD) in a heart transplant recipient with chimeric antigen receptor T‐cell therapy
Author(s) -
Dang Brian N.,
Ch’ng James,
Russell Matthew,
Cheng Jerry C.,
Moore Theodore B.,
Alejos Juan C.
Publication year - 2021
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.13861
Subject(s) - medicine , chimeric antigen receptor , immunosuppression , post transplant lymphoproliferative disorder , discontinuation , lymphoproliferative disorders , heart transplantation , transplantation , immunology , lymphoma , immunotherapy , virus , epstein–barr virus , immune system
Post‐transplant lymphoproliferative disorders (PTLD) are a group of lesions that can complicate solid organ or hematopoietic stem cell transplantation and are often associated with Epstein‐Barr virus (EBV). The treatment of PTLD is dependent on the type of lesion and includes a wide range of therapies, but chimeric antigen receptor (CAR) T‐cell therapy has not previously been reported as a treatment option for PTLD. We present a patient who developed refractory PTLD in her right retroperitoneum, right inguinal and iliac chains, and right axillary region shortly after heart transplantation and was treated with CAR T‐cell therapy. She could not tolerate complete discontinuation of immunosuppression due to the risk of rejection of a life‐supporting graft. The patient's PTLD responded to CAR T‐cell therapy, and her heart was monitored throughout the treatment course without any signs of rejection or ventricular dysfunction. CAR T‐cell therapy may be a viable treatment option in patients who develop PTLD after a solid organ transplant.