nach oben

Strahlentherapie und Onkologie

Erschienen in:

22.06.2016 | Case Study

Post-transplant lymphoproliferative disorder in the pelvis successfully treated with consolidative radiotherapy

verfasst von: Omar Habibeh, Khaled Elsayad, Jan Kriz, Uwe Haverkamp, Hans Theodor Eich

Erschienen in: Strahlentherapie und Onkologie | Ausgabe 1/2017

Einloggen, um Zugang zu erhalten

Abstract

Background

Post-transplant lymphoproliferative disorders (PTLDs) are aggressive malignancies which represent one of the major post-transplant complications. However, treatment options vary significantly and localized disease may be curatively treated with radiotherapy (RT) or surgery. We report a case of recurrent rectal PTLD, which was successfully treated by chemoimmunotherapy followed by RT.

Case presentation

We describe a patient who developed a rectal lymphoproliferative lesion 11 years after kidney transplant, which was successfully treated with consolidative RT using 25.4 Gy sequential to chemoimmunotherapy (R-CHOP). RT was well tolerated and the patient showed no signs of grade 3 or 4 toxicity. This patient is free of recurrence 52 months after RT, with an overall survival of 62 months since diagnosis.

Conclusion

Conventionally fractionated moderate-dose RT appears to be a tolerable and effective treatment option for localized PTLD if a sufficient systemic treatment cannot be applied.

Taylor AL, Marcus R, Bradley JA (2005) Post-transplant lymphoproliferative disorders (PTLD) after solid organ transplantation. Crit Rev Oncol Hematol 56(1):155–167. doi:10.1016/j.critrevonc.2005.03.015 CrossRefPubMed

Mucha K, Foroncewicz B, Ziarkiewicz-Wróblewska B et al (2010) Post-transplant lymphoproliferative disorder in view of the new WHO classification: a more rational approach to a protean disease? Nephrol Dial Transplant 25(7):2089–2098. doi:10.1093/ndt/gfq231 CrossRefPubMed

Nalesnik MA, Jaffe R, Starzl TE et al (1988) The pathology of posttransplant lymphoproliferative disorders occurring in the setting of cyclosporine A‑prednisone immunosuppression. Am J Pathol 133(1):173–192PubMedPubMedCentral

Jagadeesh D, Woda BA, Draper J et al (2012) Post transplant Lymphoproliferative disorders: Risk, classification, and therapeutic recommendations. Curr Treat Options Oncol 13(1):122–136. doi:10.1007/s11864-011-0177-x CrossRefPubMed

Timms JM, Bell A, Flavell JR et al (2003) Target cells of Epstein-Barr-Virus (EBV)-positive post-transplant lymphoproliferative disease: Similarities to EBV-positive Hodgkin’s lymphoma. Lancet 361(9353):217–223. doi:10.1016/S0140-6736(03)12271-4 CrossRefPubMed

Parker A, Bowles K, Bradley JA et al (2010) Management of post-transplant lymphoproliferative disorder in adult solid organ transplant recipients – BCSH and BTS Guidelines. Br J Haematol 149(5):693–705. doi:10.1111/j.1365-2141.2010.08160.x CrossRefPubMed

Koffman BH, Kennedy AS, Heyman M et al (2000) Use of radiation therapy in posttransplant lymphoproliferative disorder (PTLD) after liver transplantation. Int J Cancer 90(2):104–109CrossRefPubMed

Yahalom J, Illidge T, Specht L et al (2015) Modern radiation therapy for Extranodal lymphomas. field and dose guidelines from the international Lymphoma radiation oncology group. Int J Radiat Oncol 92(1):11–31. doi:10.1016/j.ijrobp.2015.01.009 CrossRef

Campo E, Swerdlow SH, Harris NL et al (2011) The 2008 WHO classification of lymphoid neoplasms and beyond: Evolving concepts and practical applications. Blood 117(19):5019–5032. doi:10.1182/blood-2011-01-293050 CrossRefPubMedPubMedCentral

10.

Parker A, Bowles K, Bradley JA et al (2010) Diagnosis of post-transplant lymphoproliferative disorder in solid organ transplant recipients – BCSH and BTS Guidelines. Br J Haematol 149(5):675–692. doi:10.1111/j.1365-2141.2010.08161.x CrossRefPubMed

11.

Jagadeesh D, Hooda S, Fenner KB et al (2014). Post Transplant Lymphoproliferative Disorders (PTLD) after Solid Organ Transplant: Cleveland Clinic Experience. Blood 124(21), 3008. Retrieved from http://www.bloodjournal.org/content/124/21/3008. Accessed 20 June 2016.

12.

Jacobsen ED, Sharman JP, Oki Y et al (2015) Brentuximab vedotin demonstrates objective responses in a phase 2 study of relapsed/refractory DLBCL with variable CD30 expression. Blood. 2015 Feb 26;125(9):1394-402. doi: 10.1182/blood-2014-09-598763.

13.

Izadi M, Fazel M, Saadat SH et al (2011) Radiotherapy is the best treatment method in post transplant lymphoproliferative disorders localizing in brain: a review of the literature. Annals of transplantation : quarterly of the Polish Transplantation. Society 16(4):126–133

14.

Henkenberens C, Franzke A, Raab P et al (2014) Primary EBV-positive Hodgkin’s lymphoma of the CNS under azathioprine treatment. Strahlenther Onkol 190(9):847–852. doi:10.1007/s00066-014-0670-9 CrossRefPubMed

15.

Buell JF, Gross TG, Hanaway MJ et al (2005) Posttransplant Lymphoproliferative disorder. Significance of central nervous system involvement. Transplant Proc 37(2):954–955. doi:10.1016/j.transproceed.2004.12.130 CrossRefPubMed

16.

Dotti G, Fiocchi R, Motta T et al (2002) Lymphomas occurring late after solid-organ transplantation – Influence of treatment on the clinical outcome. Transplantation 74(8):1095–1102CrossRefPubMed

17.

Koffman BH, Kennedy AS, Heyman M et al (2000) Use of radiation therapy in posttransplant lymphoproliferative disorder (PTLD) after liver transplantation. Int J Cancer 90(2):104–109CrossRefPubMed

18.

Corn BW, Donahue BR, Rosenstock JG et al (1997) Palliation of AIDS-related primary lymphoma of the brain: observations from a multi-institutional database. Int J Radiat Oncol Biol Phys 38(3):601–605CrossRefPubMed

19.

Lowry L, Smith P, Qian W et al (2011) Reduced dose radiotherapy for local control in non-Hodgkin lymphoma: a randomised phase III trial. Radiotherapy and oncology. Radiol Oncol 100(1):86–92. doi:10.1016/j.radonc.2011.05.013 CrossRef

20.

Elsayad K, Kriz J, Moustakis C et al (2015) Total skin electron beam for primary cutaneous T‑cell lymphoma. Int J Radiat Oncol Biol Phys 93(5):1077–1086. doi:10.1016/j.ijrobp.2015.08.041 CrossRefPubMed

21.

Akhtari M, Reddy JP, Pinnix CC et al (2016) Primary cutaneous B‑cell lymphoma (non-leg type) has excellent outcomes even after very low dose radiation as single-modality therapy. Leuk Lymphoma 57(1):34–38. doi:10.3109/10428194.2015.1040012 CrossRefPubMed

22.

Fakhrian K, Klemm S, Keller U et al (2013) Radiotherapy in stage I‑III follicular non-Hodgkin lymphoma. Retrospective analysis of a series of 50 patients. Strahlenther Onkol 189(2):168 doi:10.1007/s00066-012-0279-9 CrossRef

23.

Vargo JA, Gill BS, Balasubramani GK et al (2015) Treatment selection and survival outcomes in early-stage diffuse large B‑cell lymphoma: Do we still need consolidative radiotherapy? J Clin Oncol 33(32):3710 doi:10.1200/JCO.2015.61.7654 CrossRefPubMed

24.

Nieder C (2016) Ist beim diffus großzelligen B‑Zell-Lymphom im frühen Stadium nach der Chemotherapie eine konsolidierende Strahlentherapie erforderlich? Strahlenther Onkol doi:10.1007/s00066-016-0967-y

25.

Elsayad K, Eich HT (2016) Überlebensvorteil durch konsolidierende Strahlentherapie bei Patienten mit diffusem großzelligen B-Zell-Lymphom in den Frühstadien. Strahlenther Onkol doi:10.1007/s00066-016-0992-x

26.

Hernando-Requejo O, Lopez M, Cubillo A et al (2014) Complete pathological responses in locally advanced rectal cancer after preoperative IMRT and integrated-boost chemoradiation. Strahlenther Onkol 190(6):515–520. doi: 10.1007/s00066-014-0650-0 CrossRefPubMed

27.

Tsai DE, Stadtmauer EA, Canaday DJ et al (1998) Combined radiation and chemotherapy in posttransplant lymphoproliferative disorder. Med Oncol 15(4):279-81. doi: 10.1007/BF02787213

28.

Karuturi M, Shah N, Frank D et al (2013) Plasmacytic post-transplant lymphoproliferative disorder: a case series of nine patients. Transpl Int. 26(6):616-22. doi: 10.1111/tri.12091

Titel: Post-transplant lymphoproliferative disorder in the pelvis successfully treated with consolidative radiotherapy
verfasst von: Omar Habibeh
Khaled Elsayad
Jan Kriz
Uwe Haverkamp
Hans Theodor Eich
Publikationsdatum: 22.06.2016
Verlag: Springer Berlin Heidelberg
Erschienen in: Strahlentherapie und Onkologie / Ausgabe 1/2017
Print ISSN: 0179-7158
Elektronische ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-016-1006-8

Neu im Fachgebiet Onkologie

23.04.2024 | Medikamente in Schwangerschaft und Stillzeit | Nachrichten

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Post-transplant lymphoproliferative disorder in the pelvis successfully treated with consolidative radiotherapy

Abstract

Background

Case presentation

Conclusion

Neu im Fachgebiet Onkologie

ICI-Therapie in der Schwangerschaft wird gut toleriert

Krebspatienten impfen: Was? Wen? Und wann nicht?

Müde im Alter? Auch an die Nebenniere denken

Stufenschema weist Prostatakarzinom zuverlässig nach

Update Onkologie

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Abstract

Background

Case presentation

Conclusion

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 1/2017

Kein Nachweis einer Ergebnisverbesserung der Salvage-Radiotherapie beim asymptomatischen biochemischen Prostatakarzinom rezidiv nach Prostatektomie durch additive Androgensuppression

Patient-related quality assurance with different combinations of treatment planning systems, techniques, and machines

Expression of Ku70 predicts results of radiotherapy in prostate cancer

Prostate bed target interfractional motion using RTOG consensus definitions and daily CT on rails

Targeted intraoperative radiotherapy tumour bed boost during breast-conserving surgery after neoadjuvant chemotherapy

Dynamic contrast-enhanced MRI for automatic detection of foci ﻿of residual or recurrent disease after prostatectomy

Neu im Fachgebiet Onkologie

ICI-Therapie in der Schwangerschaft wird gut toleriert

Krebspatienten impfen: Was? Wen? Und wann nicht?

Müde im Alter? Auch an die Nebenniere denken

Stufenschema weist Prostatakarzinom zuverlässig nach

Update Onkologie

Dynamic contrast-enhanced MRI for automatic detection of foci of residual or recurrent disease after prostatectomy