A rare case of very late onset post-transplant Burkitt lymphoma

Abstract

Post-transplant lymphoproliferative disorder typically manifests within the first year after solid organ transplantation, though it can rarely occur ten years or more post-transplant. Post-transplant Burkitt lymphoma is seldom seen following solid organ transplantation and represents an aggressive subtype. Treatment involves reducing immunosuppressive therapy alongside rituximab and the use of multiple chemotherapy agents.

Our case involves a rare occurrence of post-transplant Burkitt lymphoma 18 years after renal transplantation. Following diagnosis, the patient was switched to everolimus therapy and achieved a complete response after treatment with rituximab and chemotherapy. The patient has been in remission without further treatment for seven years. 

This case illustrates that post-transplant lymphoproliferative disorder can occur many years after transplantation, emphasizing the need for long-term vigilance in patients. The transition to sirolimus/everolimus, along with treatment protocols involving rituximab and multiple chemotherapy agents, can achieve a complete response and sustain it for extended periods for post-transplant Burkitt lymphoma.