CASE REPORT article
Front. Immunol.
Sec. Alloimmunity and Transplantation
Volume 16 - 2025 | doi: 10.3389/fimmu.2025.1597119
This article is part of the Research TopicUncovering the Immune Context of Lymphoproliferative DiseasesView all 3 articles
Case report: Dose Adjustment of Orelabrutinib for Managing Central Nervous System Post-Transplant Lymphoproliferative Disorder Following Acute Lymphoblastic Leukemia Transplantation
Provisionally accepted
- 1Department of Hematology, Taizhou Central Hospital, Taizhou, China
- 2Taizhou Central Hospital, Taizhou, China
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We report a case of acute B-cell leukemia complicated by central nervous system (CNS) posttransplant lymphoproliferative disorder (PTLD) following allogeneic hematopoietic stem cell transplantation (allo-HSCT). The patient achieved sustained disease stabilization following therapeutic dose modification of orelabrutinib, representing the first evidence-based documentation that Bruton's tyrosine kinase (BTK) inhibitor down-titration confers clinical efficacy in PTLD. Epstein-Barr virus (EBV)-associated PTLD is a serious complication following allogeneic HSCT, with frequent CNS involvement. Effective treatment for CNS involvement is often hampered by the challenge of drug penetration across the blood-brain barrier. This case highlights the potential benefit and safety of dose-adjusted orelabrutinib in controlling CNS PTLD, suggesting a promising therapeutic approach.
Keywords: Orelabrutinib, Central Nervous System, Post-transplant lymphoproliferative disorder, ebv, Btk inhibitor
Received: 26 Mar 2025; Accepted: 11 Jun 2025.
Copyright: © 2025 Wang, chen and Guan. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Lingsu Guan, Taizhou Central Hospital, Taizhou, China
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