1. Outcome of Brain Lymphoma in a High Epstein-Barr Virus-Prevalence Country After Kidney Transplantation.
- Author
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Huang YA, Wen MC, Tsai SF, Wu MJ, Yu TM, Chuang YW, Huang ST, and Chen CH
- Subjects
- Adult, Humans, Herpesvirus 4, Human genetics, Prevalence, Brain pathology, Kidney Transplantation adverse effects, Epstein-Barr Virus Infections complications, Epstein-Barr Virus Infections epidemiology, Lymphoma, Non-Hodgkin, Lymphoma, Large B-Cell, Diffuse etiology, Lymphoproliferative Disorders epidemiology, Lymphoproliferative Disorders etiology
- Abstract
Background: The incidence of post-transplant lymphoproliferative disorder (PTLD) in adult kidney transplant (KTx) recipients is less common in Taiwan. In our institute, we observed that brain lymphoma was the most notorious type., Methods: The study describes the clinical, histologic, and radiological features of primary central nervous lymphoma (PCNSL) and the outcomes and associations with Epstein-Barr virus (EBV) infection in our center., Results: Among 1470 KTx recipients, 5 patients had tissue-proven brain lymphoma (0.34%). The brain pathology disclosed diffuse large B-cell lymphoma in all patients. EBV was detected through in situ hybridization for Epstein-Barr encoding region (EBER) to disclose the EBV inclusion in the nuclei of lymphoma cells. The first treatment step was the reduction of immunosuppressants; 4 patients received whole-brain radiotherapy after complete resection of PCNSL, and 1 received concurrent chemoradiotherapy. Only one patient had poor performance status at the time of diagnosis and had a poor response to treatment with steroids. Four patients survived (mean 36.5 months, range 8.6 to 57.6 months), but one died after rapid neurologic deterioration., Conclusion: Epstein-Barr virus inclusion was found in PCNSL in our patients; however, the role of EBV in PCNSL remains to be clarified. Post-transplant lymphoproliferative disorder is a rare malignancy after KTx with a predilection of brain involvement in Taiwan. We report a successful care experience in a patient with primary CNS lymphoma with better survival., (Copyright © 2023 Elsevier Inc. All rights reserved.)
- Published
- 2023
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