Extracorporeal photochemotherapy for Epstein-Barr virus-associated lymphoma after lung transplantation

Posttransplantation lymphoproliferative disorder (PTLD) is a serious compli cation after transplantation of solid organs. Highest incidence rates have been reported for lung transplant recipients. With the current treatment st rategy for early onset PTLD, a reduction of immunosuppressive drugs, mortal ity of lung transplant recipients with PTLD remains high, due to both, inco mplete control of PTLD and transplant rejection. We present a lung transpla nt recipient with a history of acute rejection and Epstein Barr virus-assoc iated posttransplantation malignant non-Hodgkin's lymphoma. Extracorporeal photochemotherapy, in combination with a moderate reduction of immunosuppre ssive therapy, resulted in complete disappearance of PTLD, After a first ye ar of follow-up, no further rejection and no recurrence of PTLD have occurr ed. Treatment with ECP, with its beneficial effects on both, rejection afte r organ transplantation and malignant lymphoma, may be a particularly valua ble approach for the treatment of PTLD in patients after lung transplantati on, with its increased risk for transplant rejection.