B-cell lymphoproliferative disorders in solid-organ transplant patients: Detection of Epstein-Barr virus by in situ hybridization

Berg, L; Copenhaver, Cedith M.; Morrison, Vicki A.; Gruber, Scott A.; Dünn, David L.; Gajl‐Peczalska, Kazimiera J.; Strickler, John G.

doi:10.1016/0046-8177(92)90237-w

Cited by 35 publications

(14 citation statements)

References 16 publications

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“…It is strongly associated with recent EBV infection. 7,10,[20][21][22][23][24][25][26] In immunosuppressed patients, PTLD is believed to result from inadequate T-cell control over EBVdriven B-cell proliferation. 2 Data from EBV in situ Table 3.…”

Section: Discussionmentioning

confidence: 99%

“…25 A high expression of early messenger RNA transcribed by the EBER-1 gene has been observed in EBV-induced PTLD lymphoid cells. 26 The risk factors for EBV-related PTLD have been identified: primary EBV infection (EBV seronegative recipients), 27,28 transmission of donor EBV in a previously seronegative recipient, 29 cytomegalovirus (CMV) donor seropositivity and recipient seronegativity, and postoperative symptomatic CMV infection.…”

Section: Ebv In Tumor Clonalitymentioning

confidence: 99%

“…hybridization studies have been previously reported [22][23][24][25] , 19 of the 20 cases analyzed had positive EBV hybridization findings. 25 A high expression of early messenger RNA transcribed by the EBER-1 gene has been observed in EBV-induced PTLD lymphoid cells.…”

Section: Ebv In Tumor Clonalitymentioning

confidence: 99%

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Posttransplantation lymphoproliferative disorder in liver recipients: Characteristics, management, and outcome

et al. 1999

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Posttransplantation lymphoproliferative disorder (PTLD) is a well-recognized complication of organ transplantation. The aim of this study, performed over 9 years, was to examine the histopathological findings, clinical course, and outcome of patients who, having undergone orthotopic liver transplantation (OLT), developed PTLD. The sample included 7 adult liver allograft recipients (1.7%), 4 men and 3 women, with a mean age of 53 years (range, 40 to 61 years) who developed PTLD 1 to 36 months post-OLT (mean, 6 months). Four patients received either antithymocyte globulin as primary immunosuppression or OKT3 for steroidresistant cellular rejection. Four patients had localized hepatic tumor with or without regional lymph node involvement, 2 patients had extralymphoreticular disease (head of pancreas and chest wall), and 1 patient had spleen and lymph node involvement. All tumors were B-cell lymphomas; three polymorphic and four monomorphic. Clonality was assessed by immunostaining for kappa and lambda and gene rearrangement. Monoclonality was found in 4 patients and polyclonality in 2 (1 of whom progressed to monoclonality); in 2 patients, clonality could not be determined. Immunohistochemistry findings for the presence of the Epstein-Barr virus (EBV)-determined nuclear antigen and the latent membrane protein 1 were noted in lymphoma tissue in 6 patients. Immunosuppressive therapy was decreased in all patients. Polyclonal tumors were treated with acyclovir (1 patient is in complete remission and 1 patient died), and monoclonal tumors with systemic chemotherapy (2 patients are in complete remission and 2 patients died). One patient was treated with monoclonal antibodies (CD20) but failed to respond, and 1 patient was treated with excision and is in complete remission. The mortality rate was 43%; for the remainder, median survival is 21 months (range, 10 to 42 months). We conclude that PTLD may re-present early after OLT. EBV has a special role in the pathogenesis, combined with immunosuppressive therapy. The outcome is poor, and new therapeutic approaches are needed.

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Section: Discussionmentioning

confidence: 99%

Section: Ebv In Tumor Clonalitymentioning

confidence: 99%

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Posttransplantation lymphoproliferative disorder in liver recipients: Characteristics, management, and outcome

et al. 1999

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“…In immunosuppressed patients, lymphoid malignancies of B cell lineage are by far the most com monly encountered. The potentiating effect of viruses in the genesis of these lymphomas is now becoming apparent with the increasing association of Epstein-Barr virus [4,5,12], On the other hand, peripheral T cell lymphomas have only rarely been reported in renal transplant recipients [13][14][15][16][17], and evidence of HTLV-I association has been described only once [18], To our knowledge, this repre sents the first documentation of HTLV-I-associated T cell lymphoma in a renal transplant recipient, primarily in volving the native kidney. Knowledge concerning the malignant potential of HTLV-I is just evolving.…”

Section: Discussionmentioning

confidence: 99%

“…The risk of developing malignancies in renal trans plant recipients is greatly increased [1,2]. Lymphoprolif érative disorders in particular are significant [3], and B cell disorders, often associated with Epstein-Barr virus infection, predominate [4,5].…”

Section: Introductionmentioning

confidence: 99%