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Epstein–Barr virus-associated posttransplant lymphoproliferative disorder involving the central nervous system following autologous hematopoietic stem cell transplantation for neuroblastoma
- Source :
- SpringerPlus
- Publication Year :
- 2014
- Publisher :
- Springer International Publishing, 2014.
-
Abstract
- Introduction Posttransplant lymphoproliferative disorder (PTLD) is a serious complication following solid organ or hematopoietic stem cell transplantation (HSCT). Although extranodal involvement of PTLD is common, its isolated involvement in the central nervous system (CNS) is extremely rare. To date, primary CNS-PTLD has been reported in 13 patients who underwent allogeneic HSCT, but no cases have been reported in autologous HSCT recipients. Case Description Herein, we report the first report of a patient with neuroblastoma that progressed to CNS-PTLD after autologous peripheral blood stem cell transplantation (auto-PBSCT). A 27-month-old boy with stage IV neuroblastoma of the left adrenal gland received auto-PBSCT after intensive chemotherapy, tumor resection, and radiation of tumor bed and regional lymph node. An intracranial tumor in his left parietal lobe was detected by magnetic resonance imaging 99 days posttransplantation, and the tumor was completely resected. The histological diagnosis of the intracranial tumor was diffuse large B-cell lymphoma with latency type III Epstein-Barr virus infection. The patient has maintained tumor free status 3 years after auto-PBSCT. Discussion and Evaluation Given the rarity of CNS-PTLD, there is no consensus on the optimal treatment. Historically, the outcome of CNS-PTLD has been very poor. However, our patient remains free from PTLD after only total resection. The prognosis for PTLD following auto-HSCT may depend upon the underlying malignancy, immune state, EBV immune status, and treatments. Conclusions The outcome of PTLD following auto-HSCT is not necessarily poor prognosis. Further research is required to establish the optimal treatment strategy for CNS-PTLD.
- Subjects :
- Pathology
medicine.medical_specialty
medicine.medical_treatment
Hematopoietic stem cell transplantation
Malignancy
medicine.disease_cause
Neuroblastoma
hemic and lymphatic diseases
Medicine
Epstein-Barr virus
Posttransplant lymphoproliferative disorder
Extranodal Involvement
Lymph node
Multidisciplinary
Case Study
business.industry
medicine.disease
Epstein–Barr virus
Lymphoma
medicine.anatomical_structure
surgical procedures, operative
Central nervous system
business
Complication
Autologous hematopoietic stem cell transplantation
Subjects
Details
- Language :
- English
- ISSN :
- 21931801
- Volume :
- 3
- Database :
- OpenAIRE
- Journal :
- SpringerPlus
- Accession number :
- edsair.doi.dedup.....61cad0bca5d9bb0e4f99ff1809b32dd7