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Blastic Epstein-Barr virus associated post-transplant lymphoproliferative disorder after allogeneic stem cell transplantation for severe aplastic anemia

Masaaki Hotta, Aya Nakaya, Shinya Fujita, Atsushi Satake, Takahisa Nakanishi, Yoshiko Azuma, Yukie Tsubokura, Akiko Konishi, Hideaki Yoshimura, Tomoki Ito, Kazuyoshi Ishii, Shosaku Nomura
  • Masaaki Hotta
    First Department of Internal Medicine, Kansai Medical University, Hirakata, Japan
  • Aya Nakaya
    First Department of Internal Medicine, Kansai Medical University, Hirakata, Japan | nakaya1016@yahoo.co.jp
  • Shinya Fujita
    First Department of Internal Medicine, Kansai Medical University, Hirakata, Japan
  • Atsushi Satake
    First Department of Internal Medicine, Kansai Medical University, Hirakata, Japan
  • Takahisa Nakanishi
    First Department of Internal Medicine, Kansai Medical University, Hirakata, Japan
  • Yoshiko Azuma
    First Department of Internal Medicine, Kansai Medical University, Hirakata, Japan
  • Yukie Tsubokura
    First Department of Internal Medicine, Kansai Medical University, Hirakata, Japan
  • Akiko Konishi
    First Department of Internal Medicine, Kansai Medical University, Hirakata, Japan
  • Hideaki Yoshimura
    First Department of Internal Medicine, Kansai Medical University, Hirakata, Japan
  • Tomoki Ito
    First Department of Internal Medicine, Kansai Medical University, Hirakata, Japan
  • Kazuyoshi Ishii
    First Department of Internal Medicine, Kansai Medical University, Hirakata, Japan
  • Shosaku Nomura
    First Department of Internal Medicine, Kansai Medical University, Hirakata, Japan

Abstract

Post-transplant lymphoproliferative disorder (PTLD) is a well-recognized complication of organ transplantation. Progress has recently been made in the pathological classification of PTLD. However, the clinical course has not been clarified because of the rarity of this disease. We experienced a case of PTLD with a fulminant clinical course. The patient had been under longterm immunosuppressive treatment for aplastic anemia. He received related allogeneic hematopoietic stem cell transplantation. Soon after transplantation, he developed PTLD. According to the guidelines, we reduced immunosuppression. However, the disease course was so fulminant that there was no time for the patient to respond, and he died of multi-organ failure. There may be various clinical types of PTLD, which may include some fulminant cases. In such a case, it is not sufficient to reduce immunosuppression. The patient should be carefully observed and an appropriate individual treatment should be chosen.

Keywords

post-transplant lymphoproliferative disorder, allogeneic hematopoietic stem cell transplantation, aplastic anemia, Epstein-Barr Virus

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Submitted: 2017-12-09 05:50:26
Published: 2018-05-16 14:02:20
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Copyright (c) 2018 Masaaki Hotta, Aya Nakaya, Shinya Fujita, Atsushi Satake, Takahisa Nakanishi, Yoshiko Azuma, Yukie Tsubokura, Akiko Konishi, Hideaki Yoshimura, Kazuyoshi Ishii, Tomoki Ito, Shosaku Nomura

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