Anti-CD20 monoclonal antibody therapy in Epstein-Barr virus-associated B cell lymphoma following lung transplantation

Post-transplant lymphoproliferative disease is a complication of bone marro w and solid organ transplantation, mostly associated with Epstein-Barr viru s infection and chronic immunosuppression. Even if spontaneous resolution a fter cessation of immunosuppressive therapy can be observed, the prognosis of this disorder is usually poor with a low response to specific treatment. We describe a case of B-cell lymphoma of the nasopharynx occurring 6 month s after double-lung transplantation. in spite of its monoclonal nature, ant i-CD 20 monoclonal antibody given in the presence of reduced immunosuppress ion resulted in a complete response. The patient also received "consolidati on" radiation therapy to prevent the recurrence. The treatment was well tol erated with minimal side effects. The patient was asymptomatic and had a we ll functioning graft more than 1 year after therapy.