Treatment of pediatric plasma cell myeloma type post-transplant lymphoproliferative disorder with modern risk-directed therapy

Pediatr Blood Cancer. 2018 Oct;65(10):e27283. doi: 10.1002/pbc.27283. Epub 2018 Jun 12.

Abstract

Post-transplant lymphoproliferative disorder (PTLD) related plasma cell neoplasms are rare in pediatric patients. We report a pediatric liver transplant recipient with plasma cell myeloma type PTLD. Cytogenetics included 1q duplication, associated with poor prognosis in adult multiple myeloma, and t(8;14). High-risk cytogenetics has not been reported in pediatric plasma cell myeloma type PTLD. The patient was treated with bortezomib, dexamethasone, and lenalidomide with subsequent autologous stem cell transplant. He achieved a 6-year remission, demonstrating tolerance to and efficacy of this modern myeloma regimen in a pediatric patient. Unfortunately, he subsequently died from complications of repeat liver transplant.

Keywords: bortezomib; cytogenetics; lenalidomide; multiple myeloma; post-transplant lymphoproliferative disorder.

Publication types

  • Case Reports

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Child
  • Child, Preschool
  • Epstein-Barr Virus Infections / etiology
  • Hematopoietic Stem Cell Transplantation / methods
  • Humans
  • Immunocompromised Host*
  • Liver Transplantation / adverse effects*
  • Male
  • Multiple Myeloma / immunology*
  • Multiple Myeloma / therapy*