Successful Blinatumomab treatment in an allogeneic hematopoietic stem cell transplant recipient with EBV-related post-transplant lymphoproliferative disorder: A case report and literature review

Transpl Immunol. 2023 Oct:80:101895. doi: 10.1016/j.trim.2023.101895. Epub 2023 Jul 5.

Abstract

Post-transplant lymphoproliferative disorder (PTLD) is a condition in which patients experience the unrestrained proliferation of B cells as a consequence of impaired immune surveillance, almost always as a consequence of Epstein-Barr virus (EBV) infection. It remains one of the most serious potential complications that patients can experience after undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT). While treatment with rituximab can significantly improve the prognosis of individuals with EBV-PTLD, those patients in whom rituximab fails to provide appreciable clinical benefit generally exhibit very poor outcomes. In the present report, we describe the case of an EBV-PTLD patient who was successfully treated with blinatumomab and received maintenance therapy consisting of venetoclax combined with azacytidine (AZA). The present case highlights the potential utility of blinatumomab as an effective treatment option for individuals with high-risk EBV-PTLD, although further explanation of the optimal dosing and treatment duration is warranted in the future.

Keywords: Allogeneic; Blinatumomab; Epstein–Barr virus; Hematopoietic stem cell transplantation; Post-transplant lymphoproliferative disorder.

Publication types

  • Review
  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Epstein-Barr Virus Infections* / drug therapy
  • Hematopoietic Stem Cell Transplantation* / adverse effects
  • Herpesvirus 4, Human
  • Humans
  • Lymphoproliferative Disorders* / drug therapy
  • Lymphoproliferative Disorders* / etiology
  • Rituximab / therapeutic use

Substances

  • Rituximab
  • blinatumomab