Epstein‐Barr virus post‐transplant lymphoproliferative disease (<scp>PTLD</scp>) after hematopoietic stem cell transplantation

Ru, Yuhua; Chen, Jia; Wu, Depei

doi:10.1111/ejh.13131

Cited by 28 publications

(25 citation statements)

References 71 publications

(150 reference statements)

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“…Under experimental conditions PLHV-1 is associated with post-transplant lymphoproliferative disease (PTLD) in miniature pigs following allogeneic haematopoietic stem cell transplantation 50,51 . The clinical symptoms of experimental porcine PTLD, such as fever, lethargy, anorexia, high white blood cell count and palpable lymph nodes, are similar to those of human PTLD, a serious complication of solid organ and allogeneic bone marrow transplantation, which was linked to a human gammaherpesvirus, Epstein-Barr virus (human herpes virus-4, HHV-4) 52 .…”

Section: Discussionmentioning

confidence: 99%

Impact of porcine cytomegalovirus on long-term orthotopic cardiac xenotransplant survival

Denner

Laengin

Reichart

et al. 2020

Preprint

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Xenotransplantation using pig organs has achieved survival times of more than 195 days in pig orthotopic heart transplantation into baboons. Here we demonstrate that in addition to an improved immunosuppressive regimen, non-ischaemic preservation with continuous perfusion and control of post-transplantation growth of the transplant, prevention of transmission of the porcine cytomegalovirus (PCMV) plays an important role in achieving long survival times. For the first time we demonstrate that PCMV transmission in orthotopic pig heart xenotransplantation was associated with a reduced survival time of the transplant and increased levels of IL-6 and TNFα were found in the transplanted baboon. Furthermore, high levels of tPA-PAI-1 complexes were found, suggesting a complete loss of the profibrinolytic properties of the endothelial cells. These data show that PCMV has an important impact on transplant survival and call for elimination of PCMV from donor pigs.

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Section: Discussionmentioning

confidence: 99%

Impact of porcine cytomegalovirus on long-term orthotopic cardiac xenotransplant survival

Denner

Laengin

Reichart

et al. 2020

Preprint

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“…Patient B had lymphoid TB and uncommon presentation that we initially believed to be PTLD owing to EBV infection. 24,25 Unconventional, potentially invasive testing for TB should not be delayed in HSCT recipients. 1,26,27 Neither patient developed severe GVHD; however, GVHD increases the susceptibility to TB after HSCT, and the patients were receiving immunosuppressive therapies at the time of TB onset.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

<p>Identification and Treatment of Tuberculosis in Pediatric Recipients of Allogeneic Hematopoietic Stem Cell Transplantation: Case Series and Review of the Literature</p>

Wang

et al. 2020

IDR

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Background: Tuberculosis is a rare but life-threatening complication in patients who received hematopoietic stem cell transplantation. Early identification and intervention are essential to prevent severe complications. Case Presentation: We report two pediatric patients who developed tuberculosis after receiving hematopoietic stem cell transplantation for thalassemia major among 330 recipients between January 2012 and August 2019. Patient A presented with pulmonary tuberculosis and patient B presented with lymph node tuberculosis mimicking post-transplantation lymphoproliferative disorder associated with Epstein-Barr virus reactivation. Patient B's condition was deteriorated, and shortly after the initiation of anti-tuberculosis therapy, the patient was found to have disseminated pulmonary tuberculosis. Patient B was also found to have tuberculous granulomas, an uncommon manifestation of tuberculosis causing severe airway obstruction. Both patients developed critical respiratory failure and required mechanical ventilation; however, they recovered with almost full resolution of pulmonary lesions after multiple treatment adjustments. Conclusion: Tuberculosis must be carefully evaluated in all pediatric patients that receive hematopoietic stem cell transplantation, regardless of the identification of other pathogens. Prophylactic tuberculosis therapy should be considered for high-risk pediatric hematopoietic stem cell transplantation recipients from tuberculosis-endemic regions.

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“…The clinical and pathological spectrum of PTLD is variable, ranging from reactive hyperplasia to malignant lymphoma (ML), including diffuse large B-cell lymphoma (DLBCL), peripheral T-cell lymphoma (PTCL), and classic Hodgkin lymphoma (CHL). Etiologically, the majority of PTLD cases are caused by the reactivation of Epstein-Barr virus (EBV) infection, as a result of the intense immunosuppressive therapy given to these patients [7].…”

Section: Introductionmentioning

confidence: 99%

“…In immunocompetent hosts, the virus is successfully cleared by the immune system, but it persists as a latent infection in memory B cells [8,9]. The dormant virus reactivates in immunocompromised individuals where the impaired immune response, mediated by T cells, fails to control the proliferation of EBV-infected B cells, leading to the development of LPD and PTLD [7].…”

Section: Introductionmentioning

confidence: 99%

Epstein–Barr Virus-Induced Post-Transplant Lymphoproliferative Disorder of the Central Nervous System Successfully Treated with Chemo-Immunotherapy

Inoue

Rai

Tanaka

et al. 2020

Viruses

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Aplastic anemia is a rare blood disease characterized by the destruction of the hematopoietic stem cells (HSC) in the bone marrow that, in the majority of cases, is caused by an autoimmune reaction. Patients with aplastic anemia are treated with immunosuppressive drugs and some of them, especially younger individuals with a donor available, can be successfully treated with hematopoietic stem cell transplantation (HSCT). We report here a rare case of post-transplant lymphoproliferative disorder (PTLD) associated with Epstein–Barr virus (EBV) reactivation in a 30-year-old female patient who underwent allogeneic HSCT for severe aplastic anemia. The PTLD, which was diagnosed 230 days after transplantation, was localized exclusively in the central nervous system (specifically in the choroid plexus) and manifested with obvious signs of intracranial hypertension. After receiving three cycles of high dose methotrexate (HD-MTX) combined with rituximab, the patient achieved a complete clinical recovery with normalization of blood cell counts, no evidence of EBV reactivation, and no associated neurotoxicity.

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Epstein‐Barr virus post‐transplant lymphoproliferative disease (PTLD) after hematopoietic stem cell transplantation

Cited by 28 publications

References 71 publications

Impact of porcine cytomegalovirus on long-term orthotopic cardiac xenotransplant survival

Impact of porcine cytomegalovirus on long-term orthotopic cardiac xenotransplant survival

<p>Identification and Treatment of Tuberculosis in Pediatric Recipients of Allogeneic Hematopoietic Stem Cell Transplantation: Case Series and Review of the Literature</p>

Epstein–Barr Virus-Induced Post-Transplant Lymphoproliferative Disorder of the Central Nervous System Successfully Treated with Chemo-Immunotherapy

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