Central nervous system post-transplant lymphoproliferative disorder after allogeneic hematopoietic stem cell transplantation: The Nagasaki transplant group experience

Hikaru Sakamoto; Hidehiro Itonaga; Jun Taguchi; Takeharu Kato; Yasushi Sawayama; Tomayoshi Hayashi; Shiro Baba; Masako Moriuchi; Koichi Ohshima; Shinichiro Yoshida; Yukiyoshi Moriuchi; Yasushi Miyazaki

doi:10.1016/j.lrr.2019.04.003

Central nervous system post-transplant lymphoproliferative disorder after allogeneic hematopoietic stem cell transplantation: The Nagasaki transplant group experience

Leuk Res Rep. 2019 Apr 22:11:27-30. doi: 10.1016/j.lrr.2019.04.003. eCollection 2019.

Authors

Affiliations

¹ Department of Hematology, Nagasaki University Hospital, Nagasaki, Japan.
² Department of Hematology, Japanese Red Cross Nagasaki Genbaku Hospital, Nagasaki, Japan.
³ Department of Hematology, National Hospital Organization Nagasaki Medical Center, Omura, Japan.
⁴ Department of Pathology, Nagasaki Prefecture Shimabara Hospital, Shimabara, Japan.
⁵ Department of Neurosurgery, Nagasaki University Hospital, Nagasaki, Japan.
⁶ Department of Pediatrics, Nagasaki University Graduate School of Biomedical Sciences, Japan.
⁷ Department of Pathology, School of Medicine, Kurume University, Kurume, Japan.
⁸ Department of Hematology, Sasebo City General Hospital, Sasebo, Japan.
⁹ Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan.

Abstract

A 17-year-old male received allogeneic transplantation for acute lymphoblastic leukemia, and presented with generalized seizures due to a solitary brain lesion with massive necrosis on day +621. Epstein-Barr virus (EBV) DNA copies were below the cut-off value in plasma. Stereotactic biopsy of the cerebral lesion confirmed the diagnosis of post-transplant lymphoproliferative disorder (PTLD) with large atypical cells positive for CD20 and EBER. In order to diagnose primary central nervous system PTLD, the biopsy should be applied as early as possible when brain lesion with necrosis develops in post-transplant patients regardless of EBV-DNA in plasma.

Keywords: Allogeneic hematopoietic stem cell transplantation; Central nervous system; Epstein–Barr virus; Post-transplant lymphoproliferative disorder.

Publication types

Case Reports