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NDT Advance Access published online on September 3, 2009
Nephrology Dialysis Transplantation, doi:10.1093/ndt/gfp444
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© The Author 2009. Published by Oxford University Press [on behalf of ERA-EDTA]. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org


Recipient-derived chronic lymphocytic leukaemia diagnosed shortly after kidney transplantation on protocol biopsy

Daan Dierickx1, Anja De Rycke2, Peter Vandenberghe3, Ann Janssens1, Evelyne Lerut4, Christiane De Wolf-Peeters4, Gregor Verhoef1 and Pieter Evenepoel2

1 Department of Hematology 2 Department of Nephrology 3 Center for Human Genetics 4 Department of Pathology, University Hospitals Gasthuisberg, Leuven, Belgium

Correspondence and offprint requests to: Daan Dierickx; E-mail: Daan.dierickx{at}uz.kuleuven.ac.be



  Abstract

Here we present the case of a patient with diagnosis of chronic lymphocytic leukaemia (CLL) on routine protocol biopsy 3 months following kidney transplantation. Genetic analysis confirmed the origin of the malignancy, being the recipient. Differential diagnosis with post-transplant lymphoproliferative disorder (PTLD) is extremely important in order to avoid unnecessary devastating treatment. This case is challenging, both in terms of making the correct diagnosis and in terms of optimal treatment. The case underscores that it is extremely important to distinguish between a pre-existing lymphoma diagnosis after transplantation and a true PTLD as the treatment options of both are very divergent.

Keywords: chronic lymphocytic leukaemia; immunosuppression; kidney transplantation; post-transplant lymphoproliferative disorder

Received for publication: 25. 6.09
Accepted in revised form: 8. 8.09


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