Post-Transplantation Lymphoproliferative Disorder of the Central Nervous System: Spectrum of Imaging Findings

Neurographics ◽  
2012 ◽  
Vol 2 (1) ◽  
pp. 2-12
Author(s):  
Tabassum A. Kennedy ◽  
Meghan G. Lubner ◽  
Wendell Lake ◽  
M. Shahriar Salamat ◽  
Lindell R. Gentry ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Lymphoproliferative Disorder ◽  
Imaging Findings ◽  
Post Transplantation ◽  
The Central Nervous System

scholarly journals Primary central nervous system post-transplantation lymphoproliferative disorder

Cancer ◽  
2010 ◽  
Vol 116 (14) ◽  
pp. 3521-3521 ◽  
Author(s):  
Daan Dierickx ◽  
Thomas Tousseyn ◽  
Gregor Verhoef
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Lymphoproliferative Disorder ◽  
Post Transplantation

Primary Central Nervous System Post-Transplantation Lymphoproliferative Disorder

2018 ◽  
Vol 102 ◽  
pp. S226
Author(s):  
Kushani Jayasinghe ◽  
David Manser ◽  
Wyburn Kate ◽  
David Gracey ◽  
Eris Josette ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Lymphoproliferative Disorder ◽  
Post Transplantation

scholarly journals Treatment of Recurrent Posttransplant Lymphoproliferative Disorder of the Central Nervous System with High-Dose Methotrexate

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Clare J. Twist ◽  
Ricardo O. Castillo
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Lymphoproliferative Disorder ◽  
Small Bowel Transplantation ◽  
Intestinal Transplantation ◽  
Complete Response ◽  
High Dose ◽  
Posttransplant Lymphoproliferative Disorder ◽  
Chop Chemotherapy ◽  
The Central Nervous System

Posttransplant lymphoproliferative disorder (PTLD) is a frequent complication of intestinal transplantation and is associated with a poor prognosis. There is currently no consensus on optimal therapy. Recurrent PTLD involving the central nervous system (CNS) represents a particularly difficult therapeutic challenge. We report the successful treatment of CNS PTLD in a pediatric patient after liver/small bowel transplantation. Initial immunosuppression (IS) was with thymoglobulin, solucortef, tacrolimus, and mycophenolate mofetil. EBV viremia developed 8 weeks posttransplantation, and despite treatment with cytogam and valganciclovir the patient developed a polymorphic, CD20+, EBV+ PTLD with peripheral lymphadenopathy. Following treatment with rituximab, the lymphadenopathy resolved, but a new monomorphic CD20−, EBV+, lambda-restricted, plasmacytoid PTLD mesenteric mass emerged. Complete response of this PTLD was achieved with 6 cycles of cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) chemotherapy; however, 4 months off therapy he developed CNS PTLD (monomorphic CD20−, EBV+, lambda-restricted, plasmacytoid PTLD) of the brain and spine. IS was discontinued and HD-MTX (2.5–5 gm/m2/dose) followed by intrathecal HD-MTX (2 mg/dose ×2-3 days Q 7–10 days per cycle) was administered Q 4–7 weeks. After 3 cycles of HD-MTX, the CSF was negative for malignant cells, MRI of head/spine showed near-complete response, and PET/CT was negative. The patient remains in complete remission now for 3.5 years after completion of systemic and intrathecal chemotherapy.Conclusion. HD-MTX is an effective therapy for CNS PTLD and recurrent PTLD that have failed rituximab and CHOP chemotherapy.

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