Posttransplant lymphoproliferative disorder following nonmyeloablative allogeneic stem cell transplantation.

Journal Article (Journal Article)

Posttransplantation lymphoproliferative disorder (PTLD) is a well-recognized complication of conventional bone marrow/stem cell and solid organ transplantation. However, not much is known about PTLD following the more recently introduced nonmyeloablative allogeneic stem cell transplantation (NMST). This study reports the findings from two cases of PTLD following NMST and compares them to the one previously reported case. The donor origin of the PTLD was determined using short tandem repeat analysis, and B- and T-cell clonalities were evaluated by polymerase chain reaction. Two cases of PTLD evolved in a total of 70 patients who have undergone NMST at our institution from 1999 to 2003. Both patients received conditioning with Fludarabine/Cytoxan/Campath 1H (alemtuzumab, anti-CD52 antibody) and T-cell-depleted donor cells with Campath-1H. Both PTLDs were EBV positive (by immunohistochemistry and in situ hybridization) with diffuse large B-cell lymphoma morphology. Our findings indicate the incidence of PTLD following NMST is 3% (2 of 70 patients from our institution and 1 of 30 from the previously reported case). All three PTLDs arose 6 to 7 months after NMST and were rapidly fatal. The pathology of the PTLD in all cases was donor origin, EBV positive, diffuse large B-cell lymphoma.

Full Text

Duke Authors

Cited Authors

  • Snyder, MJ; Stenzel, TT; Buckley, PJ; Lagoo, AS; Rizzieri, DA; Gasparetto, C; Vredenburgh, JJ; Chao, NJ; Gong, JZ

Published Date

  • June 2004

Published In

Volume / Issue

  • 28 / 6

Start / End Page

  • 794 - 800

PubMed ID

  • 15166672

International Standard Serial Number (ISSN)

  • 0147-5185

Digital Object Identifier (DOI)

  • 10.1097/01.pas.0000126052.88174.f


  • eng

Conference Location

  • United States