Complete regression of generalized plasmacytoma of lymph nodes in a liver transplant recipient during the conversion of immunosuppressive therapy from tacrolimus to everolimus
Open Access
- 21 September 2021
- journal article
- Published by IPO Association of Transplantologists in Transplantologiya
- Vol. 13 (3), 272-279
- https://doi.org/10.23873/2074-0506-2021-13-3-272-279
Abstract
Introduction. One of the serious complications after transplantation of solid organs and bone marrow is the development of post-transplant lymphoproliferative diseases.Clinical case. To evaluate the course of post-transplant lymphoproliferative diseases in the long-term in a liver transplant recipient after conversion of immunosuppressive therapy from tacrolimus to everolimus. We analyze a case of generalized primary plasmacytoma of lymph nodes with bone marrow involvement in a patient after liver transplantation.Results. After conversion of immunosuppression we observed a rapid positive trend: decreasing size of lymph nodes and regression of the level of paraprotein down to its complete disappearance. There were neither adverse events associated with everolimus for four years, nor signs of immunosuppression insufficiency.Conclusion. This Case Report is the first description of a long-term remission of nodal plasmacytoma that developed in a liver transplant recipient after complete withdrawal of calcineurin inhibitors and administration of everolimus. We suggest that the regression of post-transplant lymphoproliferative diseases after replacing calcineurin inhibitors with everolimus is associated not only with the minimization of calcineurin inhibitors exposure, but also with the antitumor effect of the everolimus itself, which prompts us to discuss the possibilities of expanding its clinical application.Keywords
This publication has 19 references indexed in Scilit:
- Post-Transplant Lymphoproliferative Disease (PTLD): Risk Factors, Diagnosis, and Current Treatment StrategiesCurrent Hematologic Malignancy Reports, 2013
- Effect of maintenance immunosuppressive drugs on virus pathobiology: evidence and potential mechanismsReviews in Medical Virology, 2012
- A Review for Solitary Plasmacytoma of Bone and Extramedullary PlasmacytomaThe Scientific World Journal, 2012
- Plasmacytoma-like post-transplant lymphoproliferative disorder, a rare subtype of monomorphic B-cell post-transplant lymphoproliferation, is associated with a favorable outcome in localized as well as in advanced disease: a prospective analysis of 8 casesHaematologica, 2011
- Extramedullary Plasmacytoma–like Posttransplantation Lymphoproliferative DisordersAmerican Journal of Clinical Pathology, 2009
- Inhibition of mTOR by sirolimus induces remission of post-transplant lymphoproliferative disordersTransplant International, 2008
- Constitutive activation of mTOR signaling pathway in post-transplant lymphoproliferative disordersLaboratory Investigation, 2007
- Sirolimus-Induced Remission of Posttransplantation Lymphoproliferative DisorderAmerican Journal of Kidney Diseases, 2006
- Post-transplant lymphoproliferative disorders (PTLD) after solid organ transplantationCritical Reviews in Oncology/Hematology, 2005
- Immunosuppressive TOR kinase inhibitor everolimus (RAD) suppresses growth of cells derived from posttransplant lymphoproliferative disorder at allograft-protecting dosesTransplantation, 2003