HODGKINS-DISEASE FOLLOWING SOLID-ORGAN TRANSPLANTATION

Background: The incidence of second malignancies is markedly increased following transplantation of solid organs. However, the development o f Hodgkin's disease has been described relatively infrequently in this setting, and there is little clinical information on these patients a nd few details on management. Patients and methods: We have reviewed t he pathologic specimens and clinical history of four patients who deve loped Hodgkin's disease following transplantation of solid organs. Res ults: Hodgkin's disease appeared 26-68 months following transplantatio n of the kidney (2 cases), liver, and heart. Three cases demonstrated evidence of Epstein-Barr virus (EBV) in Reed-Sternberg cells. One case appears to have arisen after a previous EBV-driven polymorphous lymph oproliferation. Hodgkin's disease was localized in three cases and dis seminated in one. All patients achieved remission with standard therap y and continue in remission between 9 and 61 months after therapy. Gra ft function was pre served in all patients. Conclusion: Hodgkin's dise ase occurring in the posttransplantation period should probably be tre ated like Hodgkin's disease in non-immunosuppressed patients. Prolonge d disease-free survival is possible and function of the transplanted o rgan can be preserved.