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Robison RA, Magaki S, Kheradpour A, Harder SL, Wang J, Yau D, Zuppan CW, Deisch JK. Epstein-Barr virus-associated lymphoproliferative disorder in a young child treated for Wilms tumor. Pediatr Hematol Oncol 2020; 37:645-651. [PMID: 32511040 DOI: 10.1080/08880018.2020.1771491] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- R Aaron Robison
- Department of Neurosurgery, Loma Linda University Medical Center and School of Medicine, Loma Linda, California, USA
| | - Shino Magaki
- Department of Pathology, Loma Linda University Medical Center and School of Medicine, Loma Linda, California, USA
| | - Albert Kheradpour
- Division of Hematology-Oncology, Department of Pediatrics, Loma Linda University Medical Center and School of Medicine, Loma Linda, California, USA
| | - Sheri L Harder
- Department of Radiology, Loma Linda University Medical Center and School of Medicine, Loma Linda, California, USA
| | - Jun Wang
- Department of Pathology, Loma Linda University Medical Center and School of Medicine, Loma Linda, California, USA
| | - David Yau
- Department of Pathology, Loma Linda University Medical Center and School of Medicine, Loma Linda, California, USA
| | - Craig W Zuppan
- Department of Pathology, Loma Linda University Medical Center and School of Medicine, Loma Linda, California, USA
| | - Jeremy K Deisch
- Department of Pathology, Loma Linda University Medical Center and School of Medicine, Loma Linda, California, USA
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Montague BT, Salas CM, Montague TL, Mileno MD. The immunosuppressed patient. Infect Dis (Lond) 2017. [DOI: 10.1002/9781119085751.ch28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Brian T. Montague
- Division of Infectious Diseases; University of Colorado; Aurora Colorado USA
| | | | | | - Maria D. Mileno
- Warren Alpert Medical School; Brown University; Providence Rhode Island USA
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Nakashima K, Kodama Y, Nishikawa T, Nishimura M, Ito N, Fukano R, Nomura Y, Ueba T, Inoue T, Oshima K, Okamura J, Inagaki J. Central nervous system EBV lymphoproliferative disorder in a patient with rhabdomyosarcoma. Pediatr Int 2016; 58:388-390. [PMID: 26738608 DOI: 10.1111/ped.12812] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Revised: 08/12/2015] [Accepted: 08/18/2015] [Indexed: 11/30/2022]
Abstract
Epstein-Barr virus associated lymphoproliferative disorder (EBV-LPD) occurs in patients with immunodeficiency, but it has not been well described in patients who have received chemotherapy for solid tumors. We describe a child with rhabdomyosarcoma who developed isolated central nervous system (CNS) EBV-LPD during combination chemotherapy with vincristine, actinomycin D and cyclophosphamide. The patient was treated with high-dose methotrexate (HD-MTX) for CNS EBV-LPD and then treated with rituximab in addition to HD-MTX because of the emergence of LPD in the liver. I.v. rituximab combined with HD-MTX might be effective therapy for CNS EBV-LPD.
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Affiliation(s)
- Kentaro Nakashima
- Department of Pediatrics, National Kyushu Cancer Center, Fukuoka, Japan
| | - Yuichi Kodama
- Department of Pediatrics, National Kyushu Cancer Center, Fukuoka, Japan
| | - Takuro Nishikawa
- Department of Pediatrics, National Kyushu Cancer Center, Fukuoka, Japan
| | - Miho Nishimura
- Department of Pediatrics, National Kyushu Cancer Center, Fukuoka, Japan
| | - Nobuhiro Ito
- Department of Pediatrics, National Kyushu Cancer Center, Fukuoka, Japan
| | - Reiji Fukano
- Department of Pediatrics, National Kyushu Cancer Center, Fukuoka, Japan
| | - Yuko Nomura
- Department of Pediatrics, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Tetsuya Ueba
- Department of Neurosurgery, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.,Department of Neurosurgery, Kochi Medical School, Kochi, Japan
| | - Tooru Inoue
- Department of Neurosurgery, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Koichi Oshima
- Department of Pathology, School of Medicine, Kurume University, Fukuoka, Japan
| | - Jun Okamura
- Department of Pediatrics, National Kyushu Cancer Center, Fukuoka, Japan
| | - Jiro Inagaki
- Department of Pediatrics, National Kyushu Cancer Center, Fukuoka, Japan
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Lehrnbecher T, Trusen A, Deinlein F, Höcht B, Marx A, Kühl J. B-Cell lymphoproliferative disorder not associated with Epstein-Barr Virus in a child with relapsed acute lymphoblastic leukemia. MEDICAL AND PEDIATRIC ONCOLOGY 2003; 40:13-7. [PMID: 12426680 DOI: 10.1002/mpo.10202] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Lymphoproliferative disorder (LPD) is described in only a few children receiving chemotherapy for cancer. In all of them, an association between LPD and EBV (Epstein-Barr Virus) was found. We report on a patient who developed LPD not associated with EBV while receiving chemotherapy for relapsed acute lymphoblastic leukemia (ALL). Despite discontinuation of chemotherapy, administration of intravenous immunoglobulins and surgery the patient died. Growing experience with this disorder may allow better treatment options in the future and will show whether LPD not associated with EBV requires different therapeutic strategies.
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Heath JA, Broxson EH, Dole MG, Filippa DA, George D, Lyden D, Dunkel IJ. Epstein-Barr virus-associated lymphoma in a child undergoing an autologous stem cell rescue. J Pediatr Hematol Oncol 2002; 24:160-3. [PMID: 11998794 DOI: 10.1097/00043426-200202000-00022] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Epstein-Barr virus-associated lymphoproliferative disease (EBV-LPD) is a serious disorder seen in various states of immunodeficiency, often with a fatal outcome. In this article, a patient with EBV-lymphoma after autologous stem cell rescue for treatment of a nonhematologic solid tumor is described. The child, a 4-year-old boy, had unilateral retinoblastoma with metastatic spread to the central nervous system. He had previously received both local tumor bed and craniospinal radiation therapy together with intensive myeloablative alkylator chemotherapy before autologous stem cell rescue. Histologically confirmed lymphoma with evidence of active EBV proliferation developed within cervical lymph nodes 3 weeks after his first autologous stem cell rescue. A complete clinical remission of the lymphadenopathy was obtained after infusions of rituximab (an anti-CD20 monoclonal antibody), acyclovir, and high-titer anticytomegalovirus immunoglobulin. The patient died approximately 6 months later of persistent and progressive retinoblastoma without any clinical evidence of lymphoma. It is concluded that EBV-LPD should be included in the differential diagnosis in patients in whom lymphadenopathy develops after autologous stem cell rescue.
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MESH Headings
- Acyclovir/therapeutic use
- Antibodies, Monoclonal/therapeutic use
- Antibodies, Monoclonal, Murine-Derived
- Antineoplastic Agents, Phytogenic/therapeutic use
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Antiviral Agents/therapeutic use
- Carboplatin/administration & dosage
- Central Nervous System Neoplasms/drug therapy
- Central Nervous System Neoplasms/radiotherapy
- Central Nervous System Neoplasms/secondary
- Child, Preschool
- Combined Modality Therapy
- Cyclophosphamide/therapeutic use
- Disease Progression
- Epstein-Barr Virus Infections/complications
- Epstein-Barr Virus Infections/drug therapy
- Etoposide/administration & dosage
- Eye Enucleation
- Eye Neoplasms/drug therapy
- Eye Neoplasms/pathology
- Eye Neoplasms/radiotherapy
- Eye Neoplasms/surgery
- Fatal Outcome
- Hematopoietic Stem Cell Transplantation
- Herpesvirus 4, Human/isolation & purification
- Humans
- Immunocompromised Host
- Immunoglobulins, Intravenous/therapeutic use
- Immunosuppressive Agents/adverse effects
- Immunosuppressive Agents/therapeutic use
- Immunotherapy
- Lymphoma, Large B-Cell, Diffuse/drug therapy
- Lymphoma, Large B-Cell, Diffuse/etiology
- Lymphoma, Large B-Cell, Diffuse/therapy
- Lymphoma, Large B-Cell, Diffuse/virology
- Male
- Meningeal Neoplasms/drug therapy
- Meningeal Neoplasms/radiotherapy
- Meningeal Neoplasms/secondary
- Meningeal Neoplasms/therapy
- Methylprednisolone/therapeutic use
- Neoplasm Recurrence, Local
- Neoplasms, Second Primary/drug therapy
- Neoplasms, Second Primary/etiology
- Neoplasms, Second Primary/therapy
- Neoplasms, Second Primary/virology
- Optic Nerve Neoplasms/radiotherapy
- Optic Nerve Neoplasms/secondary
- Radiotherapy, Adjuvant
- Retinoblastoma/drug therapy
- Retinoblastoma/radiotherapy
- Retinoblastoma/secondary
- Retinoblastoma/surgery
- Retinoblastoma/therapy
- Rituximab
- Thiotepa/therapeutic use
- Vincristine/therapeutic use
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Affiliation(s)
- John A Heath
- Department of Pediatrics, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA
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Atypical Lymphoproliferative Diseases. Hematology 2000. [DOI: 10.1182/asheducation.v2000.1.133.20000133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
This review addresses the clinical presentation, pathology, and therapy of several uncommon lymphoid proliferations. Because these lymphoproliferations span the characteristics of reactive polymorphous proliferations to clonal malignant neoplasms, they are often difficult to diagnose and treat effectively.In Section I, Dr. Greiner describes the pathology of the spectrum of atypical lymphoid disorders including Castleman's disease, angioimmunoblastic lymphadenopathy, lymphadenopathy in autoimmune diseases, posttransplant lymphoproliferative disorders, and X-linked lymphoproliferative disorder. The relationship to Epstein-Barr virus (EBV) and human herpsesvirus-8 (HHV-8) is discussed, and molecular diagnostic assays and principles for obtaining proper diagnostic evaluation are emphasized.In Section II, Dr. Armitage presents a practical approach to the management of Castleman's disease. The discussion includes the importance of confirmation of the histological diagnosis and careful staging evaluation, therapeutic options, and the increased risks for infection and lymphoma. The appropriate roles of surgical excision, corticosteroids, and combination chemotherapy are addressed along with alternative strategies such as anti-interleukin-6 and bone marrow transplantation.In Section III, Dr. Gross reviews the treatment of EBV-associated lymphoproliferative disorders in primary immunodeficiencies and in post-transplant patients. He gives an update on the recent molecular discoveries in X-linked lymphoproliferative disorder. Preliminary results of a phase II trial of low-dose cyclophosphamide in posttransplant lymphoproliferative disorders and the use of GM-CSF as preemptive therapy are presented.
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Abstract
Abstract
This review addresses the clinical presentation, pathology, and therapy of several uncommon lymphoid proliferations. Because these lymphoproliferations span the characteristics of reactive polymorphous proliferations to clonal malignant neoplasms, they are often difficult to diagnose and treat effectively.
In Section I, Dr. Greiner describes the pathology of the spectrum of atypical lymphoid disorders including Castleman's disease, angioimmunoblastic lymphadenopathy, lymphadenopathy in autoimmune diseases, posttransplant lymphoproliferative disorders, and X-linked lymphoproliferative disorder. The relationship to Epstein-Barr virus (EBV) and human herpsesvirus-8 (HHV-8) is discussed, and molecular diagnostic assays and principles for obtaining proper diagnostic evaluation are emphasized.
In Section II, Dr. Armitage presents a practical approach to the management of Castleman's disease. The discussion includes the importance of confirmation of the histological diagnosis and careful staging evaluation, therapeutic options, and the increased risks for infection and lymphoma. The appropriate roles of surgical excision, corticosteroids, and combination chemotherapy are addressed along with alternative strategies such as anti-interleukin-6 and bone marrow transplantation.
In Section III, Dr. Gross reviews the treatment of EBV-associated lymphoproliferative disorders in primary immunodeficiencies and in post-transplant patients. He gives an update on the recent molecular discoveries in X-linked lymphoproliferative disorder. Preliminary results of a phase II trial of low-dose cyclophosphamide in posttransplant lymphoproliferative disorders and the use of GM-CSF as preemptive therapy are presented.
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