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Pediatr Blood Cancer. 2014 Nov;61(11):2107-9. doi: 10.1002/pbc.25129. Epub 2014 Jul 25.

Successful treatment of systemic and central nervous system post-transplant lymphoproliferative disorder without the use of high-dose methotrexate or radiation.

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Department of Pediatrics, Lucile Packard Children's Hospital, Palo Alto, California.


Post-transplant lymphoproliferative disorder (PTLD) describes a spectrum of conditions with highest incidence in the first year post-solid organ transplant in pediatric patients. Central nervous system (CNS) involvement with PTLD carries high mortality risk with no consensus on optimal therapeutic regimen. We present the case of a 7-year old heart transplant patient diagnosed with widespread monomorphic, CD20+, Epstein-Barr virus-positive PTLD, including CNS involvement. In addition to immunosuppression reduction and rituximab, she was treated with multiagent systemic and intrathecal chemotherapy. She achieved a prompt and complete clinical and radiologic remission, which has been sustained for over 46 months since diagnosis.


Epstein-Barr virus (EBV); central nervous system post-transplant lymphoproliferative disorder (CNS PTLD); chemotherapy; heart transplant

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