Modified cyclophosphamide, hydroxydaunorubicin, vincristine, and prednisone therapy for posttransplantation lymphoproliferative disease in pediatric patients undergoing solid organ transplantation

J Pediatr Hematol Oncol. 2001 Oct;23(7):452-5. doi: 10.1097/00043426-200110000-00012.

Abstract

Purpose: The authors report the use of a cyclophosphamide, hydroxydaunorubicin, vincristine, and prednisone (CHOP)-based chemotherapy regimen in treating six children with posttransplantation lymphoproliferative disorder (PTLD) that developed after solid organ transplantation.

Materials and methods: The chemotherapy regimen consisted of a 29-day induction with CHOP and then as many as 15 cycles of maintenance therapy using methotrexate and cytarabine alternating with vincristine, adriamycin, mercaptopurine, and prednisone.

Results: All patients attained remission. One patient died of sepsis while in remission. Four of the five remaining patients have been followed-up in remission for as long as 8 years without losing the graft. One of the patients experienced relapse after completing therapy and subsequently died with disease.

Conclusions: The authors conclude that pediatric patients with PTLD after solid organ transplantation that fails conservative management can be treated successfully with CHOP-based chemotherapy.

MeSH terms

  • Adolescent
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Child, Preschool
  • Cyclophosphamide / therapeutic use*
  • Doxorubicin / therapeutic use*
  • Humans
  • Infant
  • Lymphoproliferative Disorders / drug therapy*
  • Lymphoproliferative Disorders / etiology
  • Neoplasm Staging
  • Organ Transplantation / adverse effects*
  • Prednisone / therapeutic use*
  • Vincristine / therapeutic use*

Substances

  • Vincristine
  • Doxorubicin
  • Cyclophosphamide
  • Prednisone

Supplementary concepts

  • CHOP protocol