Classical Hodgkin Lymphoma Presenting as A Post-Transplant Lymphoproliferative Disorder after Organ Allograft Transplantation

Background: Post-transplant lymphoproliferative disorders (PTLD) complicate 1%-8% of post-transplant patients receiving solid organ or allogeneic stem cell grafts. Classical Hodgkin lymphoma (cHL) PTLD is rare among PTLD, and its clinical course is not well described.

Methods and findings: We reviewed the published literature of cases of cHL-PTLD from 1974-2015, and described the successful treatment of a patient who presented with cHL-PTLD 4 months post liver transplantation. We treated a 66-year-old female diagnosed with stage IV Epstein-Barr Virus positive cHLPTLD with reduced doses of pharmacological immunosuppression and 4 cycles of R-ChlVPP-AV (rituximab-chlorambucil, vinblastine, procarbazine, and prednisone-adriamycin and vincristine) on a 28-day cycle. The patient achieved complete remission complicated by grade 3 neutropenia (neutrophils 500-1,000/mm3), responsive to granulocyte colony stimulating factor.

Conclusions: Although it is a rare entity among patients with PTLD, cHL-PTLD tends to respond well to combination regimens, leading to favorable outcomes.

Author(s):

Jing-Xia Li, Sakura Hosoba, Harris AC Wayne, Amanda C Box, James R Spivey, Kyle T Bradley and Edmund K Waller

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