Central nervous system lymphoproliferative disorder in pediatric kidney transplant recipients

Traum, Avram Z.; Rodig, Nancy; Pilichowska, Monika; Somers, Michael J.

doi:10.1111/j.1399-3046.2006.00497.x

Cited by 37 publications

(34 citation statements)

References 45 publications

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“…Efforts to improve CNS penetration, including dosage intensification and blood-brain barrier disruption, may enhance the activity of this agent. 27,28 …”

Section: Discussionmentioning

confidence: 99%

Primary central nervous system post‐transplantation lymphoproliferative disorder

Cavaliere

Petroni

Lopes

et al. 2010

Cancer

194

112

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BACKGROUND Primary central nervous system (CNS) post-transplantation lymphoproliferative disorder (PCNS-PTLD) is a rare complication of solid organ transplantation. The objectives of this study were to define the clinical, radiologic, and pathologic features of this disease and to explore the impact of treatment on patient outcomes. METHODS The authors reviewed the databases of participating institutions of the International Primary CNS Lymphoma Collaborative Group for cases of PCNS-PTLD. Thirty-four patients who had pathologically confirmed PCNS-PTLD without evidence of systemic PTLD were investigated retrospectively. RESULTS The median time from transplantation to diagnosis of PCNS-PTLD was 4.4 years. Disease usually was multifocal and involved any location of the brain but was most common in the cerebral hemispheres, usually in the subcortical white matter or basal ganglia. Radiographically, all lesions enhanced either homogenously or in a ring-enhancing pattern. Cerebral biopsy was required to establish diagnosis in most patients. Most patients had monomorphic, Epstein-Barr virus (EBV)-positive disease of B-cell origin. Response rates were high regardless of treatment type, and the median survival was 47 months. Age was the only factor predictive of survival. CONCLUSIONS The current study demonstrated that PCNS-PTLD is typically an EBV-induced B-cell lymphoma that is responsive to treatment with favorable survival in many patients. An aggressive approach to tissue confirmation of diagnosis and treatment with chemotherapy or radiotherapy should be strongly considered.

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“…Efforts to improve CNS penetration, including dosage intensification and blood-brain barrier disruption, may enhance the activity of this agent. 27,28 …”

Section: Discussionmentioning

confidence: 99%

Primary central nervous system post‐transplantation lymphoproliferative disorder

Cavaliere

Petroni

Lopes

et al. 2010

Cancer

194

112

View full text Add to dashboard Cite

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“…At one year, MRI showed complete disease resolution, further suggesting a role for early rituximab treatment in CNS PTLD [4]. Given the rarity of primary CNS PTLD, a review of the literature shows a few scattered case reports and series [3, 4, 6, 7, 11, 12] until 2013, when Evens et al [5] published a multicenter, international analysis of 84 cases of primary CNS PTLD. Treatment options included individual or combinations of rituximab, methotrexate, cytarabine, and whole brain radiation/cranial radiotherapy (XRT).…”

Section: Discussionmentioning

confidence: 99%

A Rare Presentation of Isolated CNS Posttransplantation Lymphoproliferative Disorder

Morris

Smith

Streicher

et al. 2017

Case Reports in Oncological Medicine

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Posttransplantation lymphoproliferative disorder (PTLD) is a recognized and extremely morbid complication of solid organ transplantation, but central nervous system involvement, particularly in isolation, is rare. There are no standardized treatment strategies for PTLD, though commonly used strategies include reduction of immunosuppression, chemotherapy, rituximab, radiation, and surgery. We present a case of an unusual morphologic variant of primary central nervous system PTLD with successful response to rituximab and cranial radiation. A 69-year-old Asian male, who underwent postrenal transplant nine years earlier, presented with a one-month history of new onset seizure activity. His evaluation revealed multiple brain lesions on magnetic resonance imaging (MRI), as well as serologic and cerebrospinal fluid studies which were positive for Epstein-Barr Virus (EBV) infection. Ultimately, he underwent craniotomy with tissue biopsy with the final pathology report showing posttransplant lymphoproliferative disorder, polymorphic type. The patient was managed with reduction in immunosuppression, rituximab therapy, and cranial radiation treatments. He had demonstrated marked improvement in his neurologic function and was ultimately discharged to inpatient rehabilitation facility.

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“…11 Only three studies involving 10 patients with PT-PCNSL treated with intravenous rituximab have been reported with overall survival of at least 20 months. 6,12,13 Resection of PCNSL has been discouraged as it causes significant neurological deficit without any survival benefit. In our case, after partial resection of tumour, WBRT and rituximab were used to treat PT-PCNSL.…”

Section: Discussionmentioning

confidence: 99%

Post-transplantation primary central nervous system lymphoma in a patient with systemic lupus erythematosus and prolonged use of immunosuppressant

Tse

Chan

et al. 2014

Hong Kong Med J

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Post-transplantation primary central nervous system lymphoma is an uncommon and fatal post-transplant lymphoproliferative disorder. Such lymphomas have been described in only a few case series in the literature. The incidence of this condition is rising with improved survival after organ transplantation. A case of post-transplantation primary central nervous system lymphoma in a young Chinese woman with systemic lupus erythematosus is described here. She presented with right-sided weakness and memory loss after tooth extraction 2 weeks before admission. Contrast computed tomography of the brain demonstrated a contrast rim-enhancing lesion over the left frontal lobe. With a history of recent dental procedure, long-term immunosuppressive therapy and computed tomography findings, cerebral abscess was highly suspected. Emergency operation was performed. Histopathology showed post-transplantation primary central nervous system lymphoma, with cells positive for B-cell marker

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Central nervous system lymphoproliferative disorder in pediatric kidney transplant recipients

Cited by 37 publications

References 45 publications

Primary central nervous system post‐transplantation lymphoproliferative disorder

Primary central nervous system post‐transplantation lymphoproliferative disorder

A Rare Presentation of Isolated CNS Posttransplantation Lymphoproliferative Disorder

Post-transplantation primary central nervous system lymphoma in a patient with systemic lupus erythematosus and prolonged use of immunosuppressant

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