[Epstein-Barr virus-associated post-transplant lymphoproliferative disorder diagnosed by the episode of intestinal perforation following allogeneic hematopoietic stem cell transplantation].

Mizuki Aimoto, Takahisa Yamane, Atushi Inoue, Dai Momose, Ran Moriguchi-Aimoto, Eri Wada-Inoue, Syuuichirou Okamoto, Hideo Koh, Takahiko Nakane, Yasunobu Takeoka, Mika Akahori-Nakamae, Saori Nishiki-Kosaka, Yoshiki Terada, Hirohisa Nakamae, Ki Ryang Koh, Takafumi Nakao, Masahiko Ohsawa, Masayuki Hino

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

A 64-year-old man was diagnosed as having acute myeloid leukemia. We performed sequential treatment with chemotherapy and reduced-intensity stem cell transplantation from an unrelated donor while the patient was in partial remission. After engraftment, he developed acute graft-versus-host disease of the gut on day 42 and steroid therapy was started. Despite transient aggravation of diarrhea, his symptoms slowly improved and the dose of steroid was tapered. On day 159, he complained of acute left lower abdominal pain. A CT scan showed perforation of the digestive tract and ileectomy was performed. At surgery, multiple ulcers of the intestine were found and one of the ulcers was perforated. Pathologically, transmural and diffuse proliferation of atypical cells in the ulcer were confirmed. Since these cells were positive for CD20 and Epstein-Barr-virus (EBV) encoded RNA, we made a diagnosis of EBV-associated post-transplant lymphoproliferative disorder (PTLD). Reduction in the dose of immunosuppressive agents and rituximab led to complete remission of PTLD. PTLD after allogeneic hematopoietic stem cell transplantation (allo-HSCT) is relatively rare, and the development of gastrointestinal perforation after allo-HSCT is very rare.

Original languageEnglish
Pages (from-to)1775-1780
Number of pages6
Journal[Rinshō ketsueki] The Japanese journal of clinical hematology
Volume51
Issue number12
Publication statusPublished - 2010 Dec 1
Externally publishedYes

ASJC Scopus subject areas

  • Medicine(all)

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    Aimoto, M., Yamane, T., Inoue, A., Momose, D., Moriguchi-Aimoto, R., Wada-Inoue, E., Okamoto, S., Koh, H., Nakane, T., Takeoka, Y., Akahori-Nakamae, M., Nishiki-Kosaka, S., Terada, Y., Nakamae, H., Koh, K. R., Nakao, T., Ohsawa, M., & Hino, M. (2010). [Epstein-Barr virus-associated post-transplant lymphoproliferative disorder diagnosed by the episode of intestinal perforation following allogeneic hematopoietic stem cell transplantation]. [Rinshō ketsueki] The Japanese journal of clinical hematology, 51(12), 1775-1780.