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Sunday 01 December 2002

Successful treatment with rituximab of lymphoproliferative disorder in a child after cardiac transplantation.

By: Herman J, Vandenberghe P, van den Heuvel I, Van Cleemput J, Winnepenninckx V, Van Damme-Lombaerts R.

J Heart Lung Transplant 2002 Dec;21(12):1304-9

Post-transplantation lymphoproliferative disorders (PTLDs) are life-threatening complications. We report the case of a 7-year-old girl in whom a lymphoproliferative disorder developed more than 2 years after cardiac transplantation. The patient was taking ganciclovir for Epstein-Barr virus hepatitis at the time the PTLD occurred. Rituximab, an anti-CD20 monoclonal antibody, given in the presence of reduced immunosuppression therapy, resulted in a complete response of the PTLD. The Epstein-Barr viral load in the peripheral blood, which was extremely high at diagnosis, dropped promptly and remained below the detection threshold 11 months after completion of therapy. We observed complete depletion of B lymphocytes until 7 months after rituximab therapy, which was associated with an important decrease in immunoglobulin levels.

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