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

Trappe, Ralf Ulrich; Oertel, Stephan; Leblond, Véronique; Mollee, Peter; Sender, Monica; Reinke, Petra; Neuhaus, R.; Lehmkuhl, H.; Horst, Heinz A.; Salles, Gilles; Morschhauser, Franck; Jaccard, Arnaud; Lamy, Thierry; Leithäuser, Malte; Zimmermann, Heiner; Anagnostopoulos, Ioannis; Raphaël, Martine; Riess, Hanno; Choquet, Sylvain

doi:10.1016/s1470-2045(11)70300-x

Cited by 332 publications

(320 citation statements)

References 31 publications

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“…Sequential immunochemotherapy with rituximab followed by chemotherapy was also proven to be safe and effective in adult B-cell and Burkitt PTLD. Trappe et al reported an overall response rate of 90%, a complete remission rate of 68% and a median overall survival of 6.6 years after sequential therapy with rituximab followed by chemotherapy in patients with adult B-cell PTLD (12).…”

Section: Discussionmentioning

confidence: 99%

Post-transplant lymphoproliferative disorder presenting with skin ulceration in a renal transplant recipient who achieved sustained remission with rituximab therapy: A case report

Law

Chan

Lai

et al. 2016

Molecular and Clinical Oncology

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Abstract. Post-transplant lymphoproliferative disorder (PTLD) is associated with a variety of clinical presentations, but rarely involves the skin. We herein report a case of PTLD presenting with skin ulceration in a renal transplant recipient. A biopsy of the ulcer confirmed the diagnosis of diffuse large B-cell lymphoma. The patient was initially treated with immunosuppression reduction, but the skin ulcer persisted. He was then treated with two courses of chemotherapy, but his condition was complicated with cryptococcal infection. Antifungal agents were administered to control the fungal infection. The patient later developed lymphoma recurrence and was successfully treated with single-agent rituximab. The patient remains well 6 years after treatment, with no evidence of disease relapse. Therefore, PTLD may manifest as skin lesions and physicians must be aware of this rare presentation.

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Section: Discussionmentioning

confidence: 99%

Post-transplant lymphoproliferative disorder presenting with skin ulceration in a renal transplant recipient who achieved sustained remission with rituximab therapy: A case report

Law

Chan

Lai

et al. 2016

Molecular and Clinical Oncology

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“…With SOT, 63% of patients who developed localized EBV-PTLD improved with radiation therapy and 65-90% of patients with EBV-PTLD responded to standard CHOP or R-CHOP. [20][21][22] In pediatric patients with rituximab-resistant EBV-PTLD after SOT, there was an 83% overall response rate to low-dose chemotherapy (cyclophosphamide 600 mg/m 2 and prednisolone every 3 weeks for 6 cycles). 23 There are some reports of the treatment of EBV-PTLD after SOT or in pediatric patients, but there are only a few reports of treatment of EBV-PTLD after HSCT, especially during the early phase after HSCT.…”

Section: Discussionmentioning

confidence: 99%

Successful Treatment of Rituximab-Resistant Epstein-Barr Virus-Associated Post-transplant Lymphoproliferative Disorder Using R-CHOP

Kuriyama

Kawano

Yamashita

et al. 2014

J Clin Exp Hematopathol

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Epstein-Barr virus (EBV)-associated post-transplant lymphoproliferative disorder (EBV-PTLD) is a complication of hematopoietic stem cell transplantation (HSCT). Standard initial treatment of patients with EBV-PTLD includes administration of rituximab or dose reduction of a calcineurin inhibitor. We report successful chemotherapeutic treatment of rituximab-resistant EBV-PTLD after HSCT in a patient with severe aplastic anemia (AA). A 38-year-old woman with antithymocyte globulin (ATG)-resistant severe AA received bone marrow transplantation from an unrelated donor (human leukocyte antigen-DR singlelocus mismatch). The conditioning regimen included fludarabine, cyclophosphamide, ATG, and total body irradiation, and prophylaxis for graft-versus-host disease consisted of short methotrexate and tacrolimus. Neutrophil engraftment occurred on day 21. Left cervical lymph node swelling was observed after day 45, and analysis of a biopsy specimen revealed EBV-PTLD and a high blood EBV load (56,000 copies). The patient was treated with rituximab 4 times per week, but the lymphadenopathy continued and the blood EBV load increased to 96, 000 copies. Half-dose treatment with rituximab, cyclophosphamide, vincristine, doxorubicin, and prednisolone (R-CHOP) was initiated on day 71. After 32 days of treatment with R-CHOP, the patient's neutrophil level was restored to > 0.5 × 10 9 /L and both the lymphadenopathy and the blood EBV load (< 100 copies) were rapidly reduced. Although chemotherapy is not preferred soon after HSCT, it may be an effective strategy for treating patients with rituximab-resistant EBV-PTLD. 〔J Clin Exp Hematop 54(2) : 149-153, 2014〕

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“…It is stated that the first three doses can be administered safely without affecting lymphocyte but remaining dosages to be planned according to white cell and platelet count 69 . The recipient should also receive Cytomegalovirus and Pneumocystis jiroveci pneumonia prophylaxis along with oral fluconazole.…”

Section: And54mentioning

confidence: 99%

The Anti-thymocyte Globulin use makes kidney transplantation journey smooth

Mahmood¹,

Ahmed²,

Aqeel³

et al. 2018

Int. j. endorsing health sci. res.

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Background: The most common immunosuppressant, Anti-thymocyte Globulin (ATGs) has been widely used by clinicians for the treatment and prevention of rejection at the time of organ transplant. Transplantation is the best option for the people with renal failure at end stage, requiring replacement of renal therapy. This is a promising treatment option with significant benefits in terms of mortality and morbidity. ATG prevents organ rejection by inhibition of activated T-cells and other immune and nonimmune cells. The aim of the study was to compare different induction regimens with ATG for the survival of smooth kidney transplantation. Methodology: Studies of the last 20 years, focusing on kidney transplantation and the efficacy of antithymocyte use for kidney transplantation were reviewed for the study literature. The keywords used were Kidney Transplantation, Induction agents, ATG, Allograft, Immunosuppressant Agents. Results: Literature suggested that the most important problem with transplantation is the protection of the allograft from activated immunological forces, which begin to react early in the period after transplantation and cause significant damage with serious short-term and long-term consequences. This process is called rejection, which is usually classified as cell-mediated and antibody-mediated rejection. The phenomenon mediated by cells causes concern, as it is the cause of future failures and damage to the allograft. To combat these phenomena with different results, various strategies were adopted. Among these therapies, ATG has recognized the exceptional importance of preventing cellular mediated rejection, allowing allotransplants to function smoothly with the greatest possible long-term benefits. Conclusion: It can be concluded on the basis of previous studies that ATG as an induction agent, is more efficient in reducing the rejection rate in the renal transplantation as compared with other agents.

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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

Cited by 332 publications

References 31 publications

Post-transplant lymphoproliferative disorder presenting with skin ulceration in a renal transplant recipient who achieved sustained remission with rituximab therapy: A case report

Post-transplant lymphoproliferative disorder presenting with skin ulceration in a renal transplant recipient who achieved sustained remission with rituximab therapy: A case report

Successful Treatment of Rituximab-Resistant Epstein-Barr Virus-Associated Post-transplant Lymphoproliferative Disorder Using R-CHOP

The Anti-thymocyte Globulin use makes kidney transplantation journey smooth

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