Post-transplant lymphoproliferative disorder
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7 regimens on this page
9 variants on this page
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All lines of therapy
Rituximab (Rituxan)
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Regimen #1
| Study | Evidence |
| Trappe et al. 2016 (PTLD-1) | Phase II |
This regimen is intended for B-cell PTLD.
Chemotherapy, part one
- Rituximab (Rituxan) 375 mg/m2 IV once per day on days 1, 8, 15, 22
4-week course
Patients underwent interim staging by CT between days 40 and 50; those achieving CR proceeded to part two; all others proceeded to R-CHOP.
Chemotherapy, part two
- Rituximab (Rituxan) 375 mg/m2 IV once on day 1
21-day cycle for 4 cycles
Regimen #2
| Study | Evidence |
| Oertel et al. 2005 | Phase II, <20 pts |
This regimen is intended for B-cell PTLD.
Chemotherapy, part one
- Rituximab (Rituxan) 375 mg/m2 IV once per day on days 1, 8, 15, 22
4-week course
References
- Oertel SH, Verschuuren E, Reinke P, Zeidler K, Papp-Váry M, Babel N, Trappe RU, Jonas S, Hummel M, Anagnostopoulos I, Dörken B, Riess HB. Effect of anti-CD 20 antibody rituximab in patients with post-transplant lymphoproliferative disorder (PTLD). Am J Transplant. 2005 Dec;5(12):2901-6. link to original article contains protocol PubMed
- Trappe RU, Dierickx D, Zimmermann H, Morschhauser F, Mollee P, Zaucha JM, Dreyling MH, Dührsen U, Reinke P, Verhoef G, Subklewe M, Hüttmann A, Tousseyn T, Salles G, Kliem V, Hauser IA, Tarella C, Van Den Neste E, Gheysens O, Anagnostopoulos I, Leblond V, Riess H, Choquet S. Response to Rituximab Induction Is a Predictive Marker in B-Cell Post-Transplant Lymphoproliferative Disorder and Allows Successful Stratification Into Rituximab or R-CHOP Consolidation in an International, Prospective, Multicenter Phase II Trial. J Clin Oncol. 2017 Feb 10;35(5):536-43. Epub 2016 Dec 19 link to original article contains verified protocol PubMed
R-CHOP
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R-CHOP: Rituximab, Cyclophosphamide, Hydroxydaunorubicin (Doxorubicin), Oncovin (Vincristine), Prednisone
Regimen
| Study | Evidence |
| Trappe et al. 2016 (PTLD-1) | Phase II |
This regimen is intended for B-cell PTLD, and is for patients not achieving CR after rituximab x 4.
Chemotherapy
- Rituximab (Rituxan) 375 mg/m2 IV once on day 1
- Cyclophosphamide (Cytoxan) 750 mg/m2 IV once on day 1
- Doxorubicin (Adriamycin) 50 mg/m2 IV once on day 1
- Vincristine (Oncovin) 1.4 mg/m2 (maximum dose of 2 mg per cycle) IV once on day 1
- Prednisone (Sterapred) 50 mg/m2 PO once per day on days 1 to 5
Supportive medications
- G-CSF was required
- PJP prophylaxis was recommended
21-day cycle for 4 cycles
References
- Trappe RU, Dierickx D, Zimmermann H, Morschhauser F, Mollee P, Zaucha JM, Dreyling MH, Dührsen U, Reinke P, Verhoef G, Subklewe M, Hüttmann A, Tousseyn T, Salles G, Kliem V, Hauser IA, Tarella C, Van Den Neste E, Gheysens O, Anagnostopoulos I, Leblond V, Riess H, Choquet S. Response to Rituximab Induction Is a Predictive Marker in B-Cell Post-Transplant Lymphoproliferative Disorder and Allows Successful Stratification Into Rituximab or R-CHOP Consolidation in an International, Prospective, Multicenter Phase II Trial. J Clin Oncol. 2017 Feb 10;35(5):536-43. Epub 2016 Dec 19 link to original article contains verified protocol PubMed
R -> CHOP
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R -> CHOP: Rituximab followed by Cyclophosphamide, Hydroxydaunorubicin (Doxorubicin), Oncovin (Vincristine), Prednisone
Regimen
| Study | Evidence |
| Trappe et al. 2011 (PTLD-1) | Phase II |
Chemotherapy, rituximab portion
- Rituximab (Rituxan) 375 mg/m2 IV once per day on days 1, 8, 15, 22
4-week course, followed in 4 weeks by:
Chemotherapy, CHOP portion
- Cyclophosphamide (Cytoxan) 750 mg/m2 IV once on day 1
- Doxorubicin (Adriamycin) 50 mg/m2 IV once on day 1
- Vincristine (Oncovin) 1.4 mg/m2 (maximum dose of 2 mg per cycle) IV once on day 1
- Prednisone (Sterapred) 50 mg/m2 PO once per day on days 1 to 5
Supportive medications
- G-CSF was required
- PJP prophylaxis was recommended
21-day cycle for 4 cycles
References
- Trappe R, Oertel S, Leblond V, Mollee P, Sender M, Reinke P, Neuhaus R, Lehmkuhl H, Horst HA, Salles G, Morschhauser F, Jaccard A, Lamy T, Leithäuser M, Zimmermann H, Anagnostopoulos I, Raphael M, Riess H, Choquet S; German PTLD Study Group.; European PTLD Network. Sequential treatment with rituximab followed by CHOP chemotherapy in adult B-cell post-transplant lymphoproliferative disorder (PTLD): the prospective international multicentre phase 2 PTLD-1 trial. Lancet Oncol. 2012 Feb;13(2):196-206. Epub 2011 Dec 13. link to SD article contains verified protocol PubMed
R-CP
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R-CP: Rituximab, Cyclophosphamide, Prednisone or Prednisolone
Regimen
| Study | Evidence |
| Trappe et al. 2016 (PTLD-1) | Phase II |
This regimen was intended for patients <30 years of age.
Chemotherapy
- Rituximab (Rituxan) as follows:
- Cycles 1 & 2: 375 mg/m2 IV once per day on days 1, 8, 15
- Cyclophosphamide (Cytoxan) 600 mg/m2 IV once on day 1
- ONE of the following steroids:
- Prednisone (Sterapred) 1 mg/kg PO BID on days 1 to 5
- Methylprednisolone (Solumedrol) 0.8 mg/kg IV q12h on days 1 to 5
21-day cycle for 6 cycles
References
- Gross TG, Orjuela MA, Perkins SL, Park JR, Lynch JC, Cairo MS, Smith LM, Hayashi RJ. Low-dose chemotherapy and rituximab for posttransplant lymphoproliferative disease (PTLD): a Children's Oncology Group Report. Am J Transplant. 2012 Nov;12(11):3069-75. link to PMC article contains verified protcol PubMed