Post‑transplant lymphoproliferative disorder presenting as a tumor adjacent to the renal allograft: A case report and review of the literature

Gao,Chen; Peng,Longkai; Peng,Fenghua; Tuo,Ting; Li,Daiqiang

doi:10.3892/ol.2014.2586

Post‑transplant lymphoproliferative disorder presenting as a tumor adjacent to the renal allograft: A case report and review of the literature

Authors:
- Chen Gao
- Longkai Peng
- Fenghua Peng
- Ting Tuo
- Daiqiang Li
View Affiliations

Affiliations: Department of Urological Organ Transplantation, Second Xiangya Hospital, Central South University, Changsha, Hunan 41011, P.R. China, Department of Pathology, Second Xiangya Hospital, Central South University, Changsha, Hunan 41011, P.R. China
Published online on: October 2, 2014 https://doi.org/10.3892/ol.2014.2586
Pages: 2607-2610

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

Post‑transplant lymphoproliferative disorder (PTLD) is a potentially fatal complication of solid organ transplantation. The current report presents the case of a 42‑year‑old male who developed PTLD within the first year following renal transplantation. The disorder manifested as a tumor adjacent to the lower pole of the renal allograft and resulted in urinary obstruction. Durable complete remission was achieved as a result of surgical resection followed by a reduction in immunosuppression and low‑dose rituximab‑based chemotherapy, indicating that this therapeutic strategy may be safe and effective for the treatment of specific cases of localized and resectable PTLD.

View Figures

View References

1	Everly MJ, Bloom RD, Tsai DE and Trofe J: Posttransplant lymphoproliferative disorder. Ann Pharmacother. 41:1850–1858. 2007.
2	Dierickx D, Tousseyn T, De Wolf-Peeters C, Pirenne J and Verhoef G: Management of posttransplant lymphoproliferative disorders following solid organ transplant: an update. Leuk Lymphoma. 52:950–961. 2011.
3	Caillard S, Lelong C, Pessione F and Moulin B; French PTLD Working Group. Post-transplant lymphoproliferative disorders occurring after renal transplantation in adults: report of 230 cases from the French Registry. Am J Transplant. 6:2735–2742. 2006.
4	Khedmat H and Taheri S: Early onset post transplantation lymphoproliferative disorders: analysis of international data from 5 studies. Ann Transplant. 14:74–77. 2009.
5	Morton M, Coupes B, Roberts SA, et al: Epidemiology of posttransplantation lymphoproliferative disorder in adult renal transplant recipients. Transplantation. 95:470–478. 2013.
6	Ghobrial IM, Habermann TM, Macon WR, et al: Differences between early and late posttransplant lymphoproliferative disorders in solid organ transplant patients: are they two different diseases? Transplantation. 79:244–247. 2005.
7	Tsao L and Hsi ED: The clinicopathologic spectrum of posttransplantation lymphoproliferative disorders. Arch Pathol Lab Med. 131:1209–1218. 2007.
8	Kew CE II, Lopez-Ben R, Smith JK, et al: Posttransplant lymphoproliferative disorder localized near the allograft in renal transplantation. Transplantation. 69:809–814. 2000.
9	Palmer BF, Sagalowsky AI, McQuitty DA, Dawidson I, Vazquez MA and Lu CY: Lymphoproliferative disease presenting as obstructive uropathy after renal transplantation. J Urol. 153:392–394. 1995.
10	Khedmat H and Taheri S: Characteristics and prognosis of post-transplant lymphoproliferative disorders within renal allograft: Report from the PTLD. Int Survey Ann Transplant. 15:80–86. 2010.
11	Cosio FG, Nuovo M, Delgado L, et al: EBV kidney allograft infection: possible relationship with a peri-graft localization of PTLD. Am J Transplant. 4:116–123. 2004.
12	Caillard S, Porcher R, Provot F, et al: Post-transplantation lymphoproliferative disorder after kidney transplantation: report of a nationwide French registry and the development of a new prognostic score. J Clin Oncol. 31:1302–1309. 2013.
13	Quinlan SC, Pfeiffer RM, Morton LM and Engels EA: Risk factors for early-onset and late-onset post-transplant lymphoproliferative disorder in kidney recipients in the United States. Am J Hematol. 86:206–209. 2011.
14	Bakker NA, van Imhoff GW, Verschuuren EA, et al: HLA antigens and post renal transplant lymphoproliferative disease: HLA-B matching is critical. Transplantation. 80:595–599. 2005.
15	Reshef R, Vardhanabhuti S, Luskin MR, et al: Reduction of immunosuppression as initial therapy for posttransplantation lymphoproliferative disorder. Am J Transplant. 11:336–347. 2011.
16	Parker A, Bowles K, Bradley JA, et al: Haemato-oncology Task Force of the British Committee for Standards in Haematology and British Transplantation Society: Management of post-transplant lymphoproliferative disorder in adult solid organ transplant recipients - BCSH and BTS Guidelines. Br J Haematol. 149:693–705. 2010.
17	Svoboda J, Kotloff R and Tsai DE: Management of patients with post-transplant lymphoproliferative disorder: the role of rituximab. Transpl Int. 19:259–269. 2006.
18	Trappe R, Oertel S, Leblond V, et al; German PTLD Study Group; European PTLD Network. Sequential treatment with rituximab followed by CHOP chemotherapy in adult B-cell post-transplant lymphoproliferative disorder (PTLD): the prospective international multicentre phase 2 PTLD-1 trial. Lancet Oncol. 13:196–206. 2012.
19	Trappe R, Hinrichs C, Appel U, et al: Treatment of PTLD with rituximab and CHOP reduces the risk of renal graft impairment after reduction of immunosuppression. Am J Transplant. 9:2331–2337. 2009.
20	Foroncewicz B, Mucha K, Usiekniewicz J, et al: Posttransplant lymphoproliferative disorder of the lung in a renal transplant recipient treated successfully with surgery. Transplant Proc. 38:173–176. 2006.
21	Moudouni SM, Tligui M, Doublet JD, Haab F, Gattegno B and Thibault P: Lymphoproliferative disorder presenting as a tumor of the renal allograft. Int Urol Nephrol. 38:779–782. 2006.
22	André N, Roquelaure B and Conrath J: Molecular effects of cyclosporine and oncogenesis: a new model. Med Hypotheses. 63:647–652. 2004.
23	Pascual J: Post-transplant lymphoproliferative disorder - the potential of proliferation signal inhibitors. Nephrol Dial Transplant. 22(Suppl 1): i27–i35. 2007.
24	Alexandru S, Gonzalez E, Grande C, et al: Monotherapy rapamycin in renal transplant recipients with lymphoma successfully treated with rituximab. Transplant Proc. 41:2435–2437. 2009.
25	DiNardo CD and Tsai DE: Treatment advances in posttransplant lymphoproliferative disease. Curr Opin Hematol. 17:368–374. 2010.