Lones M A, Kirov I, Said J W, Shintaku I P, Neudorf S
Pathology Department, Children's Hospital of Orange County/St Joseph Hospital, Orange, CA 92863-5600, USA.
Bone Marrow Transplant. 2000 Nov;26(9):1021-4. doi: 10.1038/sj.bmt.1702593.
Post-transplant lymphoproliferative disorder (PTLD) is a complication of allogeneic bone marrow transplantation (BMT). Rare cases of PTLD after autologous BMT have been reported only in adults. This case report is the first to describe PTLD in a pediatric patient after autologous peripheral stem cell transplantation (PSCT). This 2-year-old male with stage IV neuroblastoma underwent autologous PSCT. The post-PSCT course was complicated by fever with hematochezia and a lung mass. On day 94 post PSCT, colonoscopy revealed an ulcer due to a PTLD, monomorphic type, B cell phenotype, associated with Epstein-Barr virus. Fine needle aspiration identified the lung mass as neuroblastoma. PTLD can occur in pediatric autologous PSCT recipients, and may occur more frequently in autologous grafts manipulated by T cell depletion or CD34+ cell selection.
移植后淋巴细胞增生性疾病(PTLD)是同种异体骨髓移植(BMT)的一种并发症。自体BMT后发生PTLD的罕见病例仅在成人中有报道。本病例报告首次描述了一名儿科患者在自体外周干细胞移植(PSCT)后发生PTLD的情况。这名患有IV期神经母细胞瘤的2岁男性接受了自体PSCT。PSCT后的病程因发热伴便血和肺部肿块而复杂化。在PSCT后第94天,结肠镜检查发现一个由PTLD引起的溃疡,为单形性类型,B细胞表型,与爱泼斯坦-巴尔病毒相关。细针穿刺确定肺部肿块为神经母细胞瘤。PTLD可发生于儿科自体PSCT受者,并且在经T细胞清除或CD34+细胞选择处理的自体移植物中可能更频繁地发生。