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Published on: March 30, 2018
Central nervous system EBV lymphoproliferative disorder in a patient with rhabdomyosarcoma
Kentaro Nakashima1, Yuichi Kodama1, Takuro Nishikawa1
1Department of Pediatrics, National Kyushu Cancer Center, Fukuoka, Japan.
Insights
Epstein-Barr virus-associated lymphoproliferative disorder (EBV-LPD) is rare in chemotherapy patients. A child with rhabdomyosarcoma successfully treated for CNS EBV-LPD with rituximab and high-dose methotrexate offers a potential therapeutic approach.
Area of Science:
- Pediatric Oncology
- Infectious Diseases
- Hematology
Background:
- Epstein-Barr virus-associated lymphoproliferative disorder (EBV-LPD) typically occurs in immunocompromised individuals.
- EBV-LPD in patients undergoing chemotherapy for solid tumors is not well-documented.
- Rhabdomyosarcoma treatment regimens can increase susceptibility to EBV-LPD.
Abstract:
Epstein-Barr virus associated lymphoproliferative disorder (EBV-LPD) occurs in patients with immunodeficiency, but it has not been well described in patients who have received chemotherapy for solid tumors. We describe a child with rhabdomyosarcoma who developed isolated central nervous system (CNS) EBV-LPD during combination chemotherapy with vincristine, actinomycin D and cyclophosphamide. The patient was treated with high-dose methotrexate (HD-MTX) for CNS EBV-LPD and then treated with rituximab in addition to HD-MTX because of the emergence of LPD in the liver. I.v. rituximab combined with HD-MTX might be effective therapy for CNS EBV-LPD.
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