A case of posttransplantation lymphoproliferative disorder in hematopoietic stem cell transplantation / 대한내과학회지

ABSTRACT

Posttransplantation lymphoproliferative disorder (PTLD) is a potentially fatal complication of hematopoietic stem cell transplantation (HPSCT) that occurs relatively early after the transplantation. The occurrence of PTLD is usually associated with Epstein-Barr virus (EBV) infection in patients who are treated by aggressive immunosuppressive therapy. PTLD presents as diverse manifestations, ranging from reactive lymphoid hyperplasia to high grade malignant lymphoma. In the present work, we describe a case of PTLD that was successfully treated with R-CHOP (rituximab, cyclophosphamide, adriamycin, vincristine, and prednisolone) chemotherapy in a 21-year-old female who received HLA-matched sibling HPSCT for severe aplastic anemia. At 120 days after transplantation, she had symptoms of dysphagia and a foreign body sensation in the throat and was diagnosed as PTLD, diffuse large B cell lymphoma involving a tonsil, cervical lymph nodes, an adrenal gland, and the liver. Three courses of R-CHOP resulted in complete remission.