Hodgkin disease after renal transplantation in childhood

Purpose: Hodgkin disease (HD) has rarely been described in organ transplant recipients. We herewith report two cases of Epstein-Barr virus (EBV) associated HD that occurred in renal transplant recipients during childhood. Patients: A 19-year-old who had a renal transplant at 12 years of age developed mixed cellularity HD 1 year following diagnosis of an EBV- associated lymphoproliferative disorder. The second case is an 18-year-old man who developed nodular sclerosing HD 7 years after renal transplantation. Results: EBV latent membrane protein-1 antigen was strongly expressed in the Hodgkin Reed-Sternberg cells in both cases. These patients achieved complete remission with standard chemotherapy without unusual toxicity. Conclusions: Renal transplant recipients on immunosuppressive therapy can develop Hodgkin disease. A review of literature on this subject with emphasis on recent molecular studies on EBV-associated cases and observed increase in incidence of HD in HIV seropositive individuals is presented.