Outcome of Rapamycin Therapy for PostTransplant- Lymphoproliferative Disorder after Kidney Transplantation: Case Series

  • Farzaneh Ashrafi Hematology Division of Internal Medicine Department, Isfahan University of Medical Sciences, Isfahan, Iran.
  • Shahrzad Shahidi Nephrology Division of Internal Medicine Department, Isfahan University of Medical Sciences, Isfahan, Iran ; Kidney Disease Research Center, Isfahan, Iran.
  • Zeinab Ebrahimi Mail Isfahan University of Medical Sciences, Isfahan, Iran.
  • Mojgan Mortazavi Isfahan Kidney Disease Research Center, Isfahan, Iran.
Keywords:
Lymphoma Therapy, Rapamycin, Transplant

Abstract

Background: Post-transplant lymphoproliferative disorders (PTLD) are a complication of chronic immunosuppressive therapy in solid organ transplantation with a high mortality rate. Alternative treatments such as rapamycin have been explored.
Methods:
A detailed retrospective analysis was performed according to data collected from 13 patients with PTLD. At the time of PTLD diagnosis, immunosuppressive therapy was decreased and rapamycin administered. Overall survival, disease-free survival of patients and graft survival were determined.
Results: Among 590 kidney transplant recipients, 13 adult patients with PTLD were included in this study. The mean age of the patients was 42.15 (range: 25-58) years at the time of PTLD diagnosis, and 9 patients were male. Histology was distributed in 9 diffuse large B cell, 1 Malt lymphoma, 1 Burkitt lymphoma, 2 Hodgkin-like PTLD. The response rate to rapamycin alone was 30.8%. The mean overall survival period was 23.38 months and 11 patients are still alive. In total, 10 patients (76.9%) achieved a complete remission with functioning graft in 11 (84.6%) patients.
Conclusion: Despite the retrospective focus and limited number of patients, this study provides promising results regarding the effectiveness of stopping calcineurin inhibitors and switching to rapamycin for patients with PTLD.

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How to Cite
1.
Ashrafi F, Shahidi S, Ebrahimi Z, Mortazavi M. Outcome of Rapamycin Therapy for PostTransplant- Lymphoproliferative Disorder after Kidney Transplantation: Case Series. Int J Hematol Oncol Stem Cell Res. 9(1):26-32.
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