Today we saw a case of a patient with renal transplant who developed CMV esophagitis and also has a newly diagnosed high grade B-cell neoplasm in need of chemotherapy.
This raised a number of questions which I have attempted to answer with the associated references.
1) How do we manage this patient?
2) When can we safely provide cancer treatment?
3) Why did this happen?
The American Journal of Transplantation has a set of guidelines which has recently been updated. The guidelines for CMV prevention and treatment are available here. These guidelines are similar, but in the bone marrow transplant population.
This article looks at risk factors in renal transplantation for developing CMV disease.
This article addresses what happens to patients with pre-existing CMV disease (or recently treated) who go on to SCTx.
Finally, this article describes/summarizes post transplant lymphoproliferative disorder (PTLD) which this patient's lymphoma likely is related to.
No comments:
Post a Comment