Scholarlink

Background <p>Post-transplant lymphoproliferative disorder (PTLD) is a serious complication of pediatric kidney transplantation. PTLD confined to the kidney allograft is uncommon, and optimal management in this setting remains uncertain.</p> Case presentation <p>An eight-year-old boy with chronic kidney disease stage G5D due to posterior urethral valves developed monomorphic PTLD limited to the kidney allograft one year after deceased-donor kidney transplantation. Histopathology demonstrated high-grade B-cell lymphoma of the activated B-cell phenotype, with negative Epstein–Barr virus DNA and low-level cytomegalovirus DNA without evidence of end-organ disease. In the absence of systemic disease, a multidisciplinary team pursued a graft-preserving strategy rather than upfront nephrectomy, consisting of reduction of immunosuppression and rituximab-based chemoimmunotherapy with cyclophosphamide, prednisolone, and rituximab (CPR). Despite treatment-related cytopenias and transient hemodialysis, the patient achieved complete metabolic remission on PET-CT and remains disease-free with preserved graft function at five years of follow-up.</p> Conclusion <p>This case demonstrates that graft-preserving, risk-adapted chemoimmunotherapy can achieve durable remission in selected pediatric patients with allograft-localized PTLD while maintaining long-term kidney allograft function.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Allograft-localized post-transplant lymphoproliferative disorder in a pediatric kidney transplant recipient: a case report and focused review

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年2月6日

查看全文
  • Dorna Derakhshan,
  • Ali Derakhshan,
  • Faizan Bashir

摘要

Background

Post-transplant lymphoproliferative disorder (PTLD) is a serious complication of pediatric kidney transplantation. PTLD confined to the kidney allograft is uncommon, and optimal management in this setting remains uncertain.

Case presentation

An eight-year-old boy with chronic kidney disease stage G5D due to posterior urethral valves developed monomorphic PTLD limited to the kidney allograft one year after deceased-donor kidney transplantation. Histopathology demonstrated high-grade B-cell lymphoma of the activated B-cell phenotype, with negative Epstein–Barr virus DNA and low-level cytomegalovirus DNA without evidence of end-organ disease. In the absence of systemic disease, a multidisciplinary team pursued a graft-preserving strategy rather than upfront nephrectomy, consisting of reduction of immunosuppression and rituximab-based chemoimmunotherapy with cyclophosphamide, prednisolone, and rituximab (CPR). Despite treatment-related cytopenias and transient hemodialysis, the patient achieved complete metabolic remission on PET-CT and remains disease-free with preserved graft function at five years of follow-up.

Conclusion

This case demonstrates that graft-preserving, risk-adapted chemoimmunotherapy can achieve durable remission in selected pediatric patients with allograft-localized PTLD while maintaining long-term kidney allograft function.