LONG-TERM COMPLETE REMISSION AND IMMUNE TOLERANCE AFTER INTENSIVE CHEMOTHERAPY FOR LYMPHOPROLIFERATIVE DISORDERS COMPLICATING LIVER TRANSPLANT1

作者：Wing Hang Leung, Paul M. Colombani, Henry T. Lau, Kathleen B. Schwarz, BARBARA V. WISE, Alan D. Friedman · 发表于：Transplantation · 年份：1999 · DOI：10.1097/00007890-199906150-00018 · 被引用次数：3 · 研究领域：Viral-associated cancers and disorders、Cytomegalovirus and herpesvirus research、Organ Transplantation Techniques and Outcomes

BACKGROUND: B cell lymphoproliferative disorders (LPD) and liver rejection are major lethal complications after hepatic transplantation. Reduction in immunosuppression is the treatment for the former, but is a risk factor for the latter. METHODS: Here, we report three consecutive children with monoclonal LPD complicating orthotopic liver transplantation. All of them were treated with brief (<4 months) but intensive chemotherapy. RESULTS: These three patients have remained in complete remission for LPD for 18 months to more than 3 years. Aggressive antimicrobial prophylaxis was successful in preventing life-threatening infections. The patient who received the highest cumulative doses of chemotherapy may have also developed relative immune tolerance to the allograft. CONCLUSIONS: High-dose-intensity chemotherapy may be effective in the treatment of monoclonal LPD, as well as in the induction of immune tolerance for the prevention of allograft rejection and LPD recurrence.