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

Strahlenther Onkol. 2017 Jan;193(1):80-85. doi: 10.1007/s00066-016-1006-8. Epub 2016 Jun 22.

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.

Keywords: Epstein–Barr virus; PTLD; Radiotherapy; Rectum; Survival.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Disease-Free Survival
  • Dose Fractionation, Radiation
  • Humans
  • Kidney Transplantation / adverse effects*
  • Lymphoproliferative Disorders / etiology*
  • Lymphoproliferative Disorders / radiotherapy*
  • Male
  • Middle Aged
  • Pelvis / diagnostic imaging
  • Pelvis / radiation effects*
  • Rectal Diseases / diagnosis
  • Rectal Diseases / etiology*
  • Rectal Diseases / radiotherapy*
  • Treatment Outcome