PT  - JOURNAL ARTICLE
AU  - Brianne J Sullivan
AU  - Grace J Kim
AU  - Gabriel Sara
TI  - Treatment dilemma for survivors of rituximab-induced bowel perforation in the setting of post-transplant lymphoproliferative disorder
AID  - 10.1136/bcr-2018-226666
DP  - 2018 Nov 01
TA  - BMJ Case Reports
PG  - e226666
VI  - 11
IP  - 1
4099  - http://casereports.bmj.com/content/11/1/e226666.short
4100  - http://casereports.bmj.com/content/11/1/e226666.full
SO  - BMJ Case Reports2018 Nov 01; 11
AB  - Post-transplant lymphoproliferative disorder (PTLD) is a recognised complication of solid and haematopoietic stem cell transplant. It consists of a heterogeneous group of lymphoid neoplasms that arises secondary to post-transplant immunosuppression. Although there is no definite standard of care for the optimal treatment for PTLD, rituximab, a monoclonal antibody, with and/or without chemotherapy (usually CHOP=cytoxan, doxorubicin, vincristine, prednisone) has become a routine part of the treatment of any CD20 (+) PTLD, with response rates similar to chemotherapy with decreased toxicity. A rare and often lethal, complication of rituximab therapy for PTLD is bowel perforation secondary to tumour lysis of lymphoma involving the intestine. A small number of cases of bowel perforation have been reported, with very few documented survivors. The risk for recurrent perforation in the setting of ongoing rituximab treatment is unknown. There is sparse data supporting how to best treat the survivors.