Prospective study of sequential reduction in immunosuppression, interferon alpha-2B, and chemotherapy for posttransplantation lymphoproliferative disorder.

Publication Type:

Journal Article

Authors:

Swinnen, Lode J; LeBlanc, Michael; Grogan, Thomas M; Gordon, Leo I; Stiff, Patrick J; Miller, Alan M; Kasamon, Yvette; Miller, Thomas P; Fisher, Richard I

Source:

Transplantation, Volume 86, Issue 2, p.215-22 (2008)

Keywords:

2008, Acyclovir, Adult, Aged, Antineoplastic Agents, Cyclosporine, Female, Heart Transplantation, Humans, Immunosuppressive Agents, Interferon Alfa-2b, Kidney Transplantation, Lymphoproliferative Disorders, Male, Middle Aged, Postoperative Complications, Public Health Sciences Division, Remission Induction, Tacrolimus

Abstract:

Several interventions can cure posttransplant lymphoproliferative disease (PTLD); a sequential approach is usual, starting with reduction in immunosuppressives (RI). The efficacy of RI remains poorly defined, particularly in adults. We assessed an algorithm starting with a defined course of RI in all patients, escalating to interferon (IFN) alpha2b, and finally to chemotherapy, in a prospective multicenter phase II study of adult solid organ transplant recipients. The design predated rituximab.