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Post Cardiac Transplantation Lymphoproliferative Disorder Presenting as t(8;14) Burkitt Leukaemia/Lymphoma Treated With Low Intensity Chemotherapy and Rituximab
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Dr Kevin Windebank
Dr Bridget Wilkins
Windebank KP, Walwyn T, Kirk R, Parry G, Hasan A, Bown N, Wilkins B
Pediatric Blood & Cancer
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BackgroundPost-transplant lymphoproliferative disorder (PTLD) occasionally presents as Burkitt lymphoma/L3 leukaemia (BLL).ProcedureWe reviewed records of cases of PTLD post-cardiac transplantation (1990-2007) occurring in our unit.ResultsThere were 15 episodes in 13 patients including four cases of EBV-driven Burkitt-type disease with t(8;14) translocations presenting with advanced stage disease. The first case was treated with a variety of low dose chemotherapy combinations. Despite problems during therapy he obtained complete remission, but died from complications of pre-existing cardiac allograft vasculopathy 7 months later. The subsequent three cases were treated with a UKCCSG low stage lymphoma protocol, NHL 9001 and Rituximab. They remain in complete remission.ConclusionsIn the context of PTLD the prognostic significance of advanced stage EBV-driven BLL with the t(8;14) translocation may be different to that in immunocompetent children.
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