Epstein-Barr virus-associated post-transplant lymphoproliferative disease during dasatinib treatment occurred 10 years after umbilical cord blood transplantation
Autor: | Daigo Akahane, Seiichiro Yoshizawa, Yasuo Aota, Yuko Tanaka, Nahoko Furuya, Seiichiro Katagiri, Akiko Yamada, Mitsuru Moriyama, Moritaka Gotoh, Tamiko Suguro, Michiyo Asano, Hiroaki Fujimoto, Akihiko Gotoh, Naoya Nakamura |
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Rok vydání: | 2021 |
Předmět: |
Male
0301 basic medicine Microbiology (medical) Oncology Epstein-Barr Virus Infections Herpesvirus 4 Human medicine.medical_specialty medicine.medical_treatment 030106 microbiology Dasatinib 03 medical and health sciences 0302 clinical medicine Maintenance therapy hemic and lymphatic diseases Internal medicine Humans Medicine Pharmacology (medical) 030212 general & internal medicine business.industry Umbilical Cord Blood Transplantation Hematopoietic Stem Cell Transplantation Myeloid leukemia Immunosuppression Middle Aged medicine.disease Lymphoma Transplantation Leukemia surgical procedures operative Infectious Diseases Cord Blood Stem Cell Transplantation business medicine.drug |
Zdroj: | Journal of Infection and Chemotherapy. 27:1076-1079 |
ISSN: | 1341-321X |
Popis: | Post-transplant lymphoproliferative disease (PTLD) is defined as a lymphoma that occurs after solid-organ or hematopoietic stem-cell transplantation (HSCT), caused by immunosuppression and Epstein-Barr virus (EBV) reactivation. It is an important post-transplant complication that can be fatal. After HSCT, most PTLD occurs within 2 years. Recent evidence suggests that tyrosine kinase inhibitors (TKIs) are expected to be effective maintenance therapy after HSCT for Philadelphia chromosome-positive leukemia. However, it is unclear whether the use of TKIs might pose a risk of developing PTLD after HSCT. We present the first case of late-onset PTLD during dasatinib treatment, which occurred 10 years after umbilical cord blood transplantation (CBT). A 59-year-old man who received CBT for chronic myeloid leukemia blast phase needed long-term dasatinib therapy for molecular relapse. Ten years after CBT, he developed diffuse-large B-cell lymphoma (DLBCL). We observed chimerism of the DLBCL sample, which indicated complete donor type and EBV-DNA, and the patient was diagnosed with PTLD. Because of treatment resistance, he died 6 months after PTLD onset. Although he received no long-term administration of immunosuppressive agents, he received long-term dasatinib treatment, which suggests that prolonged dasatinib use after CBT caused EBV reactivation and led to PTLD. Our case suggests that the potential contribution of molecular-targeted agents after HSCT to the development of PTLD should be carefully considered. |
Databáze: | OpenAIRE |
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