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Successful treatment of a child with late onset T-cell post-transplant lymphoproliferative disorder/lymphoma

Authors

  • Kirsten M. Williams MD,

    1. Department of Pediatrics and Oncology, Johns Hopkins University School of Medicine, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland
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  • Meghan A. Higman MD, PhD,

    1. Department of Pediatrics and Oncology, Johns Hopkins University School of Medicine, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland
    Current affiliation:
    1. Children's Hospital of Buffalo, Department of Pediatrics—Hematology/Oncology, Buffalo, NY.
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  • Allen R. Chen MD, PhD,

    1. Department of Pediatrics and Oncology, Johns Hopkins University School of Medicine, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland
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  • Cindy L. Schwartz MD,

    1. Department of Pediatrics and Oncology, Johns Hopkins University School of Medicine, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland
    Current affiliation:
    1. Division of Pediatric Hematology/Oncology, Brown Medical School, Hasbro Children's Hospital, Providence, RI.
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  • Moody Wharam MD,

    1. Department of Pediatrics and Oncology, Johns Hopkins University School of Medicine, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland
    2. Department of Radiation Oncology, Johns Hopkins, Baltimore, Maryland
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  • Paul Colombani MD,

    1. Department of Pediatrics and Oncology, Johns Hopkins University School of Medicine, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland
    2. Department of Surgery, Johns Hopkins, Baltimore, Maryland
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  • Robert J. Arceci MD, PhD

    Corresponding author
    1. Department of Pediatrics and Oncology, Johns Hopkins University School of Medicine, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland
    • Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Bunting-Blaustein Cancer Research Building, 1650 Orleans Street, CRB 2M51, Baltimore, MD 21231.
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Abstract

We report a novel regimen for refractory post-transplant T-cell lymphoma (PTL). Our patient presented with non-Epstein–Barr virus (EBV) related, T-cell post-transplant lymphoproliferative disease (PTLD) 3.5 years after liver transplantation. Initially diagnosed as polyclonal PTLD, the disease progressed to a monoclonal, T-cell PTL that was refractory to several chemotherapy regimens but responded to a regimen consisting of fludarabine, cyclophosphamide, cytarabine, and alemtuzumab. Consolidation therapy included high-dose chemotherapy, autologous hematopoietic stem cell rescue, and radiation therapy. She remains in remission 2.5 years later. T-cell PTL is a rare disease with a poor prognosis; this regimen provides a novel, potentially curative approach for its treatment. Pediatr Blood Cancer 2008;50:667–670. © 2007 Wiley-Liss, Inc.

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