Michael J, Greenstein S, Schechner R, Tellis V, Vasovic L V, Ratech H, Glicklich D
Division of Nephrology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York 10467, USA.
Transplantation. 2003 Jun 27;75(12):2131-2. doi: 10.1097/01.TP.0000060253.54333.F3.
There have been only five reported cases of primary posttransplant T-cell lymphoma. We report the first case associated with the use of sirolimus (Rapamycin, Wyeth-Ayerst, Philadelphia, PA). The patient, receiving prednisone, cyclosporine, and sirolimus treatment, developed ascites, diarrhea, and weight loss 7 months after his second renal transplant. Tissue obtained at laparotomy established the diagnosis of primary T-cell lymphoma. Latent membrane protein-1 for Epstein-Barr virus was negative, but in-site hybridization test for Epstein-Barr-encoded RNA was positive. Despite aggressive chemotherapy, the patient died 8 months posttransplant. This is the sixth reported case of primary intestinal posttransplant T-cell lymphoma, but it is the first case associated with the use of sirolimus. The incidence of posttransplant lymphoproliferative disease in patients receiving sirolimus should be studied.
