Display options
Cite
Gładyś A, Kozak S, Wdowiak K, et al. Infectious complications during immunochemotherapy of post-transplantation lymphoproliferative disease-can we decrease the risk? Two case reports and review of literature. World J Clin Cases. 2021;9(3):748-757doi: 10.12998/wjcc.v9.i3.748.
Gładyś, A., Kozak, S., Wdowiak, K., Winder, M., & Chudek, J. (2021). Infectious complications during immunochemotherapy of post-transplantation lymphoproliferative disease-can we decrease the risk? Two case reports and review of literature. World journal of clinical cases, 9(3), 748-757. https://doi.org/10.12998/wjcc.v9.i3.748
Gładyś, Aleksandra, et al. "Infectious complications during immunochemotherapy of post-transplantation lymphoproliferative disease-can we decrease the risk? Two case reports and review of literature." World journal of clinical cases vol. 9,3 (2021): 748-757. doi: https://doi.org/10.12998/wjcc.v9.i3.748
Gładyś A, Kozak S, Wdowiak K, Winder M, Chudek J. Infectious complications during immunochemotherapy of post-transplantation lymphoproliferative disease-can we decrease the risk? Two case reports and review of literature. World J Clin Cases. 2021 Jan 26;9(3):748-757. doi: 10.12998/wjcc.v9.i3.748. PMID: 33553416; PMCID: PMC7829726.
Copy Download .nbib Format: NLM
Share it on

World J Clin Cases. 2021 Jan 26;9(3):748-757. doi: 10.12998/wjcc.v9.i3.748.

Infectious complications during immunochemotherapy of post-transplantation lymphoproliferative disease-can we decrease the risk? Two case reports and review of literature.

World journal of clinical cases

Aleksandra Gładyś, Sylwia Kozak, Kamil Wdowiak, Mateusz Winder, Jerzy Chudek

Affiliations

  1. Department of Internal Diseases and Oncological Chemotherapy, Faculty of Medical Sciences, Medical University of Silesia in Katowice, Katowice 40-027, Woj. ?l?skie, Poland. [email protected].
  2. Department of Internal Diseases and Oncological Chemotherapy, Faculty of Medical Sciences, Medical University of Silesia in Katowice, Katowice 40-027, Woj. ?l?skie, Poland.

PMID: 33553416 PMCID: PMC7829726 DOI: 10.12998/wjcc.v9.i3.748

Abstract

BACKGROUND: Post-transplant lymphoproliferative disease (PTLD) is a heterogeneous group of diseases that develop after solid organ and hematopoietic stem cells transplantation related to intensive immunosuppression regimen, T-cell depletion and Epstein-Barr virus infection. Despite the improvement in the management of PTLD, the prognosis remains poor. Here we report the management of two transplanted patients with PTLD and infections during immunochemotherapy (ICTH).

CASE SUMMARY: Of 65-year-old woman 11 years after kidney transplantation (first case) presented with diffuse large B-cell lymphoma (DLBCL) CS III and started ICHT according to R-CHOP protocol. Despite the secondary prevention of neutropenic fever, the patient developed grade 4 neutropenia with urinary and pulmonary tract infections after the fifth cycle. ICTH was continued in reduced doses up to 7 cycles followed by involved-field radiation therapy of the residual disease. The second case presents a 49-year-old man, 8 years after liver transplantation due to cirrhosis in the course of chronic hepatitis B, who started ICTH for DLBCL Burkitt-like CS IV. The patient received four cycles of ICTH according to R-CODOX/R-IVAC protocol, with reduced doses. In both cases initially undertaken reduction of immunosuppression was ineffective to prevent infectious complications. Despite one incomplete ICHT treatment due to recurrent infections, both our patients remain in complete remission.

CONCLUSION: Reduction of immunosuppression and the doses of chemotherapeutics may be insufficient to prevent infectious complications during ICTH in PTLD patients.

©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.

Keywords: Case report; Epstein-Barr virus; Immunosuppression; Lymphoma; Post-transplant lymphoproliferative disease; Transplantation

Conflict of interest statement

Conflict-of-interest statement: The authors declare that they have no conflict of interest.

References

  1. Lancet. 2013 May 25;381(9880):1817-26 - PubMed
  2. Hematology Am Soc Hematol Educ Program. 2013;2013:95-102 - PubMed
  3. Transplant Proc. 2011 Mar;43(2):551-3 - PubMed
  4. Clin Transplant. 2009 Sep-Oct;23(5):756-60 - PubMed
  5. Transplantation. 2017 Sep;101(9):2009-2016 - PubMed
  6. Semin Nephrol. 2007 Jul;27(4):445-61 - PubMed
  7. J Natl Compr Canc Netw. 2011 Aug 1;9(8):914-32 - PubMed
  8. Medicine (Baltimore). 2018 Nov;97(44):e13063 - PubMed
  9. Transplant Proc. 1995 Oct;27(5):2705-6 - PubMed
  10. J Clin Oncol. 2019 Jul 20;37(21):1790-1799 - PubMed
  11. Cancer Lett. 2015 Dec 1;369(1):37-44 - PubMed
  12. Cancer Res Treat. 2015 Jul;47(3):448-57 - PubMed
  13. Am J Transplant. 2006 Mar;6(3):569-76 - PubMed
  14. Cancer Treat Res. 2015;165:305-27 - PubMed
  15. Am J Transplant. 2007 Aug;7(8):1989-96 - PubMed
  16. Lancet Oncol. 2012 Feb;13(2):196-206 - PubMed
  17. J Natl Compr Canc Netw. 2019 Jun 1;17(6):650-661 - PubMed
  18. Adv Ther. 2017 Oct;34(10):2232-2273 - PubMed
  19. Transpl Infect Dis. 2007 Dec;9(4):302-9 - PubMed
  20. Prog Transplant. 2019 Jun;29(2):185-193 - PubMed
  21. Transplantation. 2012 Sep 15;94(5):532-8 - PubMed
  22. Curr Hematol Malig Rep. 2013 Sep;8(3):173-83 - PubMed
  23. Clin Microbiol Rev. 1997 Jan;10(1):86-124 - PubMed
  24. J Clin Oncol. 2017 Feb 10;35(5):536-543 - PubMed
  25. Transplantation. 2013 Feb 15;95(3):470-8 - PubMed
  26. Transpl Infect Dis. 2012 Dec;14(6):595-603 - PubMed
  27. Transpl Infect Dis. 1999 Mar;1(1):21-8 - PubMed
  28. Blood. 2016 May 19;127(20):2375-90 - PubMed
  29. Hematol Oncol. 2017 Jun;35(2):187-197 - PubMed
  30. Eur J Haematol. 2017 Jan;98(1):38-43 - PubMed
  31. J Bras Nefrol. 2010 Mar;32(1):75-82 - PubMed

Publication Types