胶质母细胞瘤肾移植受者的长期移植物存活:病例报告

Q4 Medicine Transplantation Reports Pub Date : 2024-06-25 DOI:10.1016/j.tpr.2024.100158
Maryam Rahbar , Marzieh Latifi , Elahe Pourhosein , Ebrahim Mahmoudi , Iman Seyhoun , Sanaz Dehghani
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引用次数: 0

摘要

移植后长期的免疫抑制会增加受体患者罹患癌症的风险。本病例报告介绍了一名肾移植受者在移植后患胶质母细胞瘤的治疗方法。患者是一名 61 岁的女性,24 年前因先天性肾病综合征接受了活体肾移植。患者接受了多种免疫抑制药物治疗,包括环孢素、泼尼松龙和霉酚酸酯。经过16年的随访,患者出现了脑肿瘤症状,于是接受了进一步检查。随后进行了手术,提取了肿瘤细胞,减轻了脑内的压力。根据病理结果,确定患者患有胶质母细胞瘤。检测到 O6-甲基鸟嘌呤-DNA 甲基转移酶(MGMT)启动子发生甲基化,这表明患者可能对化疗产生反应。在确诊和手术后,患者的肾移植药物进行了调整。雷帕霉素取代了之前的药物,降低了霉酚酸酯和泼尼松龙的剂量。7 年后,患者的肾功能良好,肌酐水平为 1.5,脑部成像也未显示异常。总之,本病例报告展示了肾移植后胶质母细胞瘤的成功治疗方法,强调了对有癌症发生风险的移植受者进行密切监测和个体化管理的必要性。考虑到目前患者在改变用药方案后病情稳定,由于环孢素具有致癌性,长期使用该药物的患者应纳入今后的评估范围。
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Long-term graft survival in a kidney transplant recipient with glioblastoma: Case report

Long-term immunosuppression after transplantation can increase the risk of cancer development in recipient patients. This case report describes the treatment approach for glioblastoma in a kidney transplant recipient after transplantation. The patient, a 61-year-old woman, received a living donor kidney transplant 24 years ago due to congenital nephrotic syndrome. The patient was on various immunosuppressive medications, including cyclosporine, prednisolone, and mycophenolate mofetil.

After 16 years of follow-up, the patient presented with symptoms of brain tumor, leading to further tests. Subsequent examination revealed the presence of a tumor that had spread to frontal region within the brain.

A surgical procedure was subsequently conducted to extract the tumor cells and alleviate the resulting pressure within the brain. Based on pathology results, it was determined that the patient had glioblastoma.

Methylation of the O6-methylguanine-DNA methyltransferase (MGMT) promoter was detected, indicating the potential response to chemotherapy. Chemotherapy was initiated, along with radiation therapy.

After the diagnosis and surgery, the patient's medications for the kidney transplant were modified. Rapamycin replaced the previous medications, and the dose of mycophenolate mofetil and prednisolone was decreased. After 7 years, the patient's kidney is functioning well, with a creatinine level of 1.5, and brain imaging showed no abnormalities. After kidney transplantation, there is an increased risk of various cancers.

Overall, this case report demonstrates a successful treatment approach for glioblastoma after kidney transplantation, emphasizing the need for close monitoring and individualized management in transplant recipients at risk for cancer development.

Considering the current stability of the patient's condition after a change in medication regimen, patients who have been using the drug Cyclosporine for a long time should be included in future evaluations due to its carcinogenic properties.

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来源期刊
Transplantation Reports
Transplantation Reports Medicine-Transplantation
CiteScore
0.60
自引率
0.00%
发文量
24
审稿时长
101 days
期刊介绍: To provide to national and regional audiences experiences unique to them or confirming of broader concepts originating in large controlled trials. All aspects of organ, tissue and cell transplantation clinically and experimentally. Transplantation Reports will provide in-depth representation of emerging preclinical, impactful and clinical experiences. -Original basic or clinical science articles that represent initial limited experiences as preliminary reports. -Clinical trials of therapies previously well documented in large trials but now tested in limited, special, ethnic or clinically unique patient populations. -Case studies that confirm prior reports but have occurred in patients displaying unique clinical characteristics such as ethnicities or rarely associated co-morbidities. Transplantation Reports offers these benefits: -Fast and fair peer review -Rapid, article-based publication -Unrivalled visibility and exposure for your research -Immediate, free and permanent access to your paper on Science Direct -Immediately citable using the article DOI
期刊最新文献
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