Skip to main content
construction release_alert
Scholars@Duke will be undergoing maintenance April 11-15. Some features may be unavailable during this time.
cancel

Posttransplant lymphoproliferative disorder after umbilical cord blood transplantation in children

Publication ,  Journal Article
Gong, JZ; Bayerl, MG; Sandhaus, LM; Sebastian, S; Rehder, CW; Routbort, M; Lagoo, AS; Szabolcs, P; Chiu, J; Comito, M; Buckley, PJ
Published in: American Journal of Surgical Pathology
2006

Reported are 7 cases of posttransplant lymphoproliferative disorder (PTLD) arising in children who received umbilical cord blood transplantation (UCBT). There were 4 females and 3 males with a median age of 3 years (range, 1-16 years). All 7 patients received UCBT, including 1 patient who received multiple units and 1 transplanted under nonmyeloablative condition. The time interval from UCBT to PTLD averaged 4 months (range, 2 weeks to 9 months). Patients typically presented with high-stage disease with visceral organ involvement. Histology of the PTLDs showed monomorphic morphology in 5 cases and polymorphic morphology in the remaining 2 cases. Bone marrow biopsies were performed in 3 cases and were negative for PTLD. Epstein-Barr virus (EBV) was detected in the PTLD in all 7 patients by in situ hybridization. Evidence of past EBV infection was found in the recipients, but the EBV genome was not detected in the donor cord blood samples, suggesting that donor cord blood was not the source of EBV infection. The origin of the PTLD was investigated in 5 cases. PTLD was of host origin in 2 patients who failed engraftment and of donor origin in the remaining 3 patients who had complete engraftment. Four of 5 patients with monomorphic PTLD failed to demonstrate significant responses to rituximab and/or reduction of immunosuppression and died within 1 month after diagnosis. The remaining 2 patients with polymorphic PTLD showed complete response to therapy. One patient was alive 35 months after transplant, and the other patient died of infection 6 months after transplant. It is concluded that PTLD arising after UCBT in children occurs early after transplant and represents a serious EBV-related complication. PTLD may be of donor or recipient origin depending on engraftment status. Both monomorphic and polymorphic histology may be seen, and monomorphic histology appears to predict an unfavorable prognosis. Copyright © 2006 by Lippincott Williams & Wilkins.

Duke Scholars

Published In

American Journal of Surgical Pathology

DOI

ISSN

0147-5185

Publication Date

2006

Volume

30

Issue

3

Start / End Page

328 / 336

Related Subject Headings

  • Pathology
  • 1103 Clinical Sciences
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Gong, J. Z., Bayerl, M. G., Sandhaus, L. M., Sebastian, S., Rehder, C. W., Routbort, M., … Buckley, P. J. (2006). Posttransplant lymphoproliferative disorder after umbilical cord blood transplantation in children. American Journal of Surgical Pathology, 30(3), 328–336. https://doi.org/10.1016/j.jallcom.2005.10.007
Gong, J. Z., M. G. Bayerl, L. M. Sandhaus, S. Sebastian, C. W. Rehder, M. Routbort, A. S. Lagoo, et al. “Posttransplant lymphoproliferative disorder after umbilical cord blood transplantation in children.” American Journal of Surgical Pathology 30, no. 3 (2006): 328–36. https://doi.org/10.1016/j.jallcom.2005.10.007.
Gong JZ, Bayerl MG, Sandhaus LM, Sebastian S, Rehder CW, Routbort M, et al. Posttransplant lymphoproliferative disorder after umbilical cord blood transplantation in children. American Journal of Surgical Pathology. 2006;30(3):328–36.
Gong, J. Z., et al. “Posttransplant lymphoproliferative disorder after umbilical cord blood transplantation in children.” American Journal of Surgical Pathology, vol. 30, no. 3, 2006, pp. 328–36. Scival, doi:10.1016/j.jallcom.2005.10.007.
Gong JZ, Bayerl MG, Sandhaus LM, Sebastian S, Rehder CW, Routbort M, Lagoo AS, Szabolcs P, Chiu J, Comito M, Buckley PJ. Posttransplant lymphoproliferative disorder after umbilical cord blood transplantation in children. American Journal of Surgical Pathology. 2006;30(3):328–336.

Published In

American Journal of Surgical Pathology

DOI

ISSN

0147-5185

Publication Date

2006

Volume

30

Issue

3

Start / End Page

328 / 336

Related Subject Headings

  • Pathology
  • 1103 Clinical Sciences