Classical Hodgkin lymphoma-type PTLD after solid organ transplantation in children: a report on 17 patients treated according to subsequent GPOH-HD treatment schedules

Leuk Lymphoma. 2017 Mar;58(3):633-638. doi: 10.1080/10428194.2016.1205742. Epub 2016 Aug 11.


Post-transplant lymphoproliferative disease (PTLD) is a severe complication after solid organ transplantation (SOT). Classical Hodgkin lymphoma-type (HL-) PTLD is a rare subtype, and systematic data on treatment and prognosis are lacking. We report on 17 pediatric patients with classical HL-PTLD. HL-PTLD developed late at a median of 8.1 years after SOT. It was commonly EBV-positive (16/17) and expressed both CD30 (all tumors) and CD20 (8/17 tumors). Patients were treated with chemotherapy +/- involved field radiotherapy (IF-RT) according to the respective GPOH-HD protocol tailored by stage and LDH. Overall survival at 2 and 5 years was 86% with 81% of patients surviving event-free. Six patients had additional rituximab treatment; in two it was given as upfront monotherapy and in four was given concurrently with their chemotherapy. Rituximab monotherapy did not lead to long-term remission. In conclusion, treatment of HL-PTLD with classical HL chemotherapy is effective and tolerable. New treatment modalities such as CD30-targeted or EBV-specific agents may diminish toxicity.

Keywords: Hodgkin lymphoma; PTLD; pediatric; solid organ transplantation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Child
  • Child, Preschool
  • Combined Modality Therapy
  • Consolidation Chemotherapy
  • Female
  • Hodgkin Disease / diagnosis
  • Hodgkin Disease / etiology*
  • Hodgkin Disease / mortality
  • Hodgkin Disease / therapy*
  • Humans
  • Lymphoproliferative Disorders / diagnosis
  • Lymphoproliferative Disorders / etiology*
  • Lymphoproliferative Disorders / mortality
  • Lymphoproliferative Disorders / therapy*
  • Male
  • Neoplasm Staging
  • Neoplasms, Second Primary / diagnosis
  • Neoplasms, Second Primary / etiology*
  • Neoplasms, Second Primary / mortality
  • Neoplasms, Second Primary / therapy*
  • Organ Transplantation / adverse effects*
  • Radiotherapy, Adjuvant
  • Remission Induction
  • Treatment Outcome
  • Young Adult