Post-transplant lymphoproliferative disorders: From epidemiology to pathogenesis-driven treatment

Petrara, Maria Raffaella; Giunco, Silvia; Serraino, Diego; Dolcetti, Riccardo; Rossi, Anita De

doi:10.1016/j.canlet.2015.08.007

Cited by 123 publications

(130 citation statements)

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“…More than 90% of B-cells in early onset and 60–80% in late onset of post-transplant lymphoproliferative disease (PTLD) are EBV positive (Petrara et al, 2015). Moreover, early onset PTLDs are either polyclonal or oligoclonal, while most of late onset PTLDs are truly monoclonal (Carbone et al, 2008).…”

Section: Ebv Associated Diseasesmentioning

confidence: 99%

Epstein–Barr Virus: Diseases Linked to Infection and Transformation

Jha

Pei

2016

Front. Microbiol.

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Epstein–Barr virus (EBV) was first discovered in 1964, and was the first known human tumor virus now shown to be associated with a vast number of human diseases. Numerous studies have been conducted to understand infection, propagation, and transformation in various cell types linked to human diseases. However, a comprehensive lens through which virus infection, reactivation and transformation of infected host cells can be visualized is yet to be formally established and will need much further investigation. Several human cell types infected by EBV have been linked to associated diseases. However, whether these are a direct result of EBV infection or indirectly due to contributions by additional infectious agents will need to be fully investigated. Therefore, a thorough examination of infection, reactivation, and cell transformation induced by EBV will provide a more detailed view of its contributions that drive pathogenesis. This undoubtedly expand our knowledge of the biology of EBV infection and the signaling activities of targeted cellular factors dysregulated on infection. Furthermore, these insights may lead to identification of therapeutic targets and agents for clinical interventions. Here, we review the spectrum of EBV-associated diseases, the role of the encoded latent antigens, and the switch to latency or lytic replication which occurs in EBV infected cells. Furthermore, we describe the cellular processes and critical factors which contribute to cell transformation. We also describe the fate of B-cells and epithelial cells after EBV infection and the expected consequences which contribute to establishment of viral-associated pathologies.

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Section: Ebv Associated Diseasesmentioning

confidence: 99%

Epstein–Barr Virus: Diseases Linked to Infection and Transformation

Jha

Pei

2016

Front. Microbiol.

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“…El riesgo de presentación es de 10 a 20 veces más alto que en la población general 1,2 . Afecta de 1 a 20 % de pacientes con TOS 2,3 . La incidencia es de 0,7 % a 2,9 % en el trasplante renal 1,3 , siendo mayor en trasplante de intestino, páncreas y pulmón (4-7 %) 1,3 .…”

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“…Afecta de 1 a 20 % de pacientes con TOS 2,3 . La incidencia es de 0,7 % a 2,9 % en el trasplante renal 1,3 , siendo mayor en trasplante de intestino, páncreas y pulmón (4-7 %) 1,3 . Se caracteriza por la producción descontrolada de linfocitos B y de linfocitos T, con menos frecuencia 3,4 .…”

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“…La incidencia es de 0,7 % a 2,9 % en el trasplante renal 1,3 , siendo mayor en trasplante de intestino, páncreas y pulmón (4-7 %) 1,3 . Se caracteriza por la producción descontrolada de linfocitos B y de linfocitos T, con menos frecuencia 3,4 . Existen factores de riesgo asociados, como raza caucásica, infección primaria por el virus Epstein Barr (EBV), uso de anticuerpos antilinfocíticos en terapia de inducción, coinfección por citomegalovirus (CMV), terapia antiviral, rechazo del injerto y tiempo previo en diálisis 2,5 .…”

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Enfermedad linfoproliferativa en el injerto renal. Reporte de un caso y revisión de la literatura

Sánchez

Padilla

Contreras

et al. 2017

Rev. Colomb. Nefrol.

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Referenciar este artículo: Rodríguez Sánchez MP, García Padilla PK, Contreras KM, González González CA, Puentes S. Enfermedad linfoproliferativa en el injerto renal. Informe de un caso y revisión de la literatura Rev. Colomb. Nefrol. 2017;4(2) ResumenLos desórdenes linfoproliferativos postrasplante (PTLD por sus siglas en inglés: Posttransplant Lymphoproliferative disorders) se presentan en 3 a 10% de adultos con trasplante de órgano sólido (TOS). Se ha asociado a infección por Virus Epstein Barr (VEB). Es difícil diferenciar PTLD de rechazo o infección viral, porque los hallazgos clínicos e histopatológicos son muy similares. Presentamos el caso de un paciente con enfermedad renal crónica (ERC) secundaria a glomerulonefritis IgM, con trasplante renal de donante cadavérico, quien presentó proteinuria y disminucuón de la función renal, se le documentó una masa en el injerto renal compatible con desorden linfoproliferativo postrasplante renal de tipo polimórfico (PTLD), VEB positivo y CD 20 positivo. El tratamiento consistió en rituximab 375 mg/m2 semanales, cuatro dosis, se realizó control con imágenes y se adicionó el esquema CHOP (ciclofosfamida, vincristina, doxorubicina). El paciente toleró de manera adecuada la quimioterapia, no requirió radioterapia, ni trasplantectomía y después del R-CHOP la masa disminuyó de manera significativa hasta desaparecer al año de seguimiento manteniendo función óptima del injerto renal. .218Abstract Posttransplant Lymphoproliferative Disorders (PTLDs) occur in 3 to 10% of adults with solid organ transplant (SOT). It has been associated with Epstein Barr Virus (EBV) infection. Differential diagnostics of PTLD from rejection or viral infection is difficult when the tumor infiltrates the graft, because the clinical and histopathological findings are similar. We report a case of patient with chronic kidney disease due to Ig M glomerulonephritis with cadaveric donor kidney transplantation who presented proteinuria and decreased glomerular filtration rate, with a solid mass at renal graft and confirmatory histology of polymorphic renal transplant lymphoproliferative disorder (PTLD), VEB positive, and CD 20 positive. The patient was treated with rituximab 375 mg / m2 weekly, four doses, followed by chemotherapy with ciclophosphamide, vincristine and doxorubicin. He didn't need radiotherapy or graft nephrectomy, with complete remission at one year of follow-up and optimal graft function.

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“…Overall, 60-80% of PTLDs are associated with Epstein-Barr virus (EBV); this can vary depending on PTLD type and time of onset after HSCT. 1,2 The majority of the general population is infected by EBV during their life, but an immunocompetent host mounts a swift immune response that controls proliferation of EBV infected B-cells. EBV then resides only in resting memory B-cells in latent form.…”

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confidence: 99%

Plasmacytic Post-transplant Lymphoproliferative Disorder – Case Report

J¹,

Radocha²,

Souček³

et al. 2017

European Oncology &Amp; Haematology

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W e present a case of a 43-year-old Caucasian female with acute myeloid leukaemia (AML), who developed Epstein-Barr virus (EBV) positive post-transplant lymphoproliferative disorder (PTLD) of duodenum, with plasma cell differentiation after second haematopoietic stem cell transplantation. The patient was given rituximab and CHOP chemotherapy (cyclophosphamide, doxorubicin, vincristine and prednisone); however, these were only temporarily effective, and the patient passed away 36 days after PTLD was diagnosed. PTLD with plasma cell differentiation is a rare type of PTLD, and there are no strict treatment guidelines. KeywordsPlasmacytoma, post-transplant lymphoproliferative disorder, PTLD, haematopoietic stem cell transplantation, HSCT Disclosure: Jiri Hanousek, Jakub Radocha, Ondrej Soucek, Lenka Pliskova, Katerina Kamaradova, Alzbeta Zavrelova and Pavel Zak have nothing to disclose in relation to this article. No funding was received in the publication of this article.Ethics: All procedures were followed in accordance with the responsible committee on human experimentation and with the Helsinki Declaration of 1975 and subsequent revisions, and informed consent was received from the patient involved in this case study.Authorship: All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship of this manuscript, take responsibility for the integrity of the work as a whole, and have given final approval to the version to be published.Open Access: This article is published under the Creative Commons Attribution Noncommercial License, which permits any non-commercial use, distribution, adaptation and reproduction provided the original author(s) and source are given appropriate credit. 1,2 The majority of the general population is infected by EBV during their life, but an immunocompetent host mounts a swift immune response that controls proliferation of EBV infected B-cells. EBV then resides only in resting memory B-cells in latent form. 3 The balance between latently infected B-cells and immune surveillance is disrupted after a patient receivesHSCT. An increase in the number of infected B-cells (almost always of donor origin) may develop into PTLD. [4][5][6] PTLDs are divided into three stages of evolution: early lesions, polymorphic PTLDs and monomorphic PTLDs. Monomorphic PTLDs are mostly derived from B-cells, but can also be of T-cell origin, and resemble aggressive non-Hodgkin lymphomas.5 PTLD resembling diffuse large B-cell lymphoma (DLBCL) is the most common.7 Rituximab, an anti CD20 monoclonal antibody, can be used effectively to treat them. 8,9 Other types of PTLD are rare and only 4% of them show plasma cell differentiation. 7,10 We would therefore like to present our patient with PTLD of duodenum with plasma cell differentiation. Case report

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Post-transplant lymphoproliferative disorders: From epidemiology to pathogenesis-driven treatment

Cited by 123 publications

References 83 publications

Epstein–Barr Virus: Diseases Linked to Infection and Transformation

Epstein–Barr Virus: Diseases Linked to Infection and Transformation

Enfermedad linfoproliferativa en el injerto renal. Reporte de un caso y revisión de la literatura

Plasmacytic Post-transplant Lymphoproliferative Disorder – Case Report

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