Post-transplantation lymphoproliferative disorders: Current concepts and future therapeutic approaches

Abbas, Fedaey; Kossi, Mohsen El; Shaheen, Ihab Sakr; Sharma, Ajay; Halawa, Ahmed

doi:10.5500/wjt.v10.i2.29

Cited by 57 publications

(73 citation statements)

References 102 publications

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“…The experience in controlling EBV in immunosuppressed patients is based on post-transplant lymphoproliferative disorders (PTLD) experience, where the mainstay is reduction of immunosuppression, which is an impossibility in primary immunodeficiency recipients. When B cell depletion with rituximab does not lead to a long-lasting control of the disease, regimens used in lymphoma therapy, such as cyclophosphamide, vincristine and prednisone, have been used despite an unsatisfactory outcome in many of these patients ( 15 ).…”

Section: Discussionmentioning

confidence: 99%

Case Report: Primary Immunodeficiencies, Massive EBV+ T-Cell Lympoproliferation Leading to the Diagnosis of ICF2 Syndrome

et al. 2021

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In immunocompromised patients, EBV may elicit B-cell transformation and proliferation. A 5-year-old microcephalic boy was admitted with fever and non-malignant polymorphic T-cell lymphoproliferative disease associated with EBV. A presumptive diagnosis of primary immunodeficiency with inability to control EBV was made and next-generation sequencing led to the identification of a novel ZBTB24 mutation (ICF2-syndrome). This case shows that susceptibility to EBV seems to be particular of ICF-2 as it has not been described in the other types of ICF. It is mandatory to raise the hypothesis of an underlying PID in case of severe EBV infection.

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Section: Discussionmentioning

confidence: 99%

Case Report: Primary Immunodeficiencies, Massive EBV+ T-Cell Lympoproliferation Leading to the Diagnosis of ICF2 Syndrome

et al. 2021

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“…In recent years, reduction of immunosuppressive therapy and/or administration of rituximab have become the primary treatment options in numerous cases, although the former must be carefully performed to prevent allograft loss. Other treatment options include donor lymphocyte infusion, cytotoxic chemotherapy, and radiotherapy ( Abbas et al 2020 ). Surgical resection is recommended only for refractory and localized PTLD cases.…”

Section: Discussionmentioning

confidence: 99%

Malignant lymphoma of the cervix in a bicollis uterus considered to be a post-transplant lymphoproliferative disorder in a patient after renal transplantation: A case report

Yoshida

Izumi

Iwashita

et al. 2020

Gynecologic Oncology Reports

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“…The overall 10-year incidence of PTLD in adult SOT recipients reported by UNOS (United Network for Organ Sharing) was 0.7% in kidney, 1% in liver, 1% in heart and pancreas, and 2% in lung transplantation [3]. The highest incidence of PTLD (19%) was reported in intestinal and multiorgan transplantation, which could be translated to almost 20 times higher relative risk compared with kidney transplantation (239.5 vs. 12.6) [4]. The variable organ-specific incidence of PTLD was also reported in children (20% in intestinal, 15% in lung, 5-10% in liver, 6% in heart, and 2-3% in kidney transplantation) [2,5].…”

Section: Incidencementioning

confidence: 99%

Non-Hodgkin lymphoma after pediatric kidney transplantation

Grenda

2021

Pediatr Nephrol

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Non-Hodgkin lymphoma (NHL) that develops after kidney transplantation belongs to post-transplant lymphoproliferative disorders (PTLD) occurring with an incidence of 2–3%. Most pediatric cases are related to primary infection with Epstein-Barr virus (EBV), able to transform and immortalize B cells and widely proliferate due to the lack of relevant control of cytotoxic T cells in patients receiving post-transplant immunosuppression. NHL may develop as a systemic disease or as a localized lesion. The clinical pattern is variable, from non-symptomatic to fulminating disease. Young age of transplant recipient, seronegative EBV status at transplantation, and EBV mismatch between donor and recipient (D+/R-) are regarded as risk factors. Immunosuppression impacts the development of both early and late NHLs. Specific surveillance protocols, including monitoring of EBV viral load, are used in patients at risk; however, detailed histopathology diagnosis and evaluation of malignancy staging is crucial for therapeutic decisions. Minimizing of immunosuppression is a primary management, followed by the use of rituximab in B-cell NHLs. Specific chemotherapeutic protocols, adjusted to lymphoma classification and staging, are used in advanced NHLs. Radiotherapy and/or surgical removal of malignant lesions is limited to the most severe cases. Outcome is variable, depending on risk factors and timing of diagnosis, however is positive in pediatric patients in terms of graft function and patient survival. Kidney re-transplantation is possible in survivors who lost the primary graft due to chronic rejection, however may be performed after at least 2–3 years of waiting time, careful verification of malignancy-free status, and gaining immunity against EBV.

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Post-transplantation lymphoproliferative disorders: Current concepts and future therapeutic approaches

Cited by 57 publications

References 102 publications

Case Report: Primary Immunodeficiencies, Massive EBV+ T-Cell Lympoproliferation Leading to the Diagnosis of ICF2 Syndrome

Case Report: Primary Immunodeficiencies, Massive EBV+ T-Cell Lympoproliferation Leading to the Diagnosis of ICF2 Syndrome

Malignant lymphoma of the cervix in a bicollis uterus considered to be a post-transplant lymphoproliferative disorder in a patient after renal transplantation: A case report

Non-Hodgkin lymphoma after pediatric kidney transplantation

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