Quantitative EBV Viral Loads and Immunosuppression Alterations can Decrease PTLD Incidence in Pediatric Liver Transplant Recipients

Lee, Timothy C.; Savoldo, Barbara; Rooney, Cliona M.; Heslop, Helen E.; Gee, Adrian P.; Caldwell, Yvette; Barshes, Neal R.; Scott, Jaymee D.; Bristow, Lisa J.; O’Mahony, Christine A.; Goss, John A.

doi:10.1111/j.1600-6143.2005.01002.x

Cited by 236 publications

(194 citation statements)

References 24 publications

(38 reference statements)

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“…This approach induces tumor regression in 25%-50% of patients [55]. Importantly, modulation of immunosuppression is currently applied by many transplant groups in patients with a high EBV-DNA viral load in order to prevent the occurrence of a PTLD [56].…”

Section: Table 3 Ebv-associated Lymphoproliferative Disorders Ebv-asmentioning

confidence: 99%

EBV-Associated Lymphoproliferative Disorders: Classification and Treatment

2008

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Since its discovery as the first human tumor virus, Epstein-Barr virus (EBV) has been implicated in the development of a wide range of B-cell lymphoproliferative disorders, including Burkitt's lymphoma, classic Hodgkin's lymphoma, and lymphomas arising in immunocompromised individuals (post-transplant and HIV-associated lymphoproliferative disorders). T-cell lymphoproliferative disorders that have been reported to be EBV associated include a subset of peripheral T-cell lymphomas, angioimmunoblastic Tcell lymphoma, extranodal nasal type natural killer/ T-cell lymphoma, and other rare histotypes. EBV encodes a series of products interacting with or exhibiting homology to a wide variety of antiapoptotic molecules, cytokines, and signal transducers, hence promoting EBV infection, immortalization, and transformation. However, the exact mechanism by which EBV promotes oncogenesis is an area of active debate. The focus of this review is on the pathology, diagnosis, classification, and pathogenesis of EBVassociated lymphomas. Recent advances in EBV cellbased immunotherapy, which is beginning to show promise in the treatment of EBV-related disorders, are discussed. The Oncologist 2008;13:577-585

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Section: Table 3 Ebv-associated Lymphoproliferative Disorders Ebv-asmentioning

confidence: 99%

EBV-Associated Lymphoproliferative Disorders: Classification and Treatment

2008

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“…Studies comparing transplant recipients receiving antiviral prophylaxis with either acyclovir or ganciclovir to historical controls, suggest some benefit from antiviral prophylaxis (73). Recently, quantitative EBV viral load monitoring has also been shown to decrease the risk of PTLD (74). PTLD PTLD is strongly associated with EBV and represents a highly diverse spectrum of disease with variable clinical presentation, from benign B cell proliferation (mononucleosis) to true monoclonal malignancy.…”

Section: Prevention Of Infectionsmentioning

confidence: 99%

Canadian Cardiovascular Society Consensus Conference update on cardiac transplantation 2008: Executive Summary

Haddad

Isaac

Légaré

et al. 2009

Canadian Journal of Cardiology

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“…Much of the work in this area has been done in the pediatric liver transplant population, because about 50% of these young patients are EBV seronegative at the time of listing [46]. A single-institution study prospectively compared the rates of PTLD in pediatric liver transplant patients before and after reverse transcription PCR EBV viral-load monitoring was instituted [47]. Prior to the monitoring of EBV levels, the institution's incidence of PTLD was 16%.…”

Section: Preventionmentioning

confidence: 99%

Malignancy After Solid Organ Transplantation: An Overview

2008

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Disclosure:This article discusses the use of acitretin (manufactured by Connetics) for prophylaxis of non-melanoma skin cancers; cyclophosphamide * (Bristol-Myers Squibb), adriamycin * (Pharmacia), prednisone * (Pfizer), vindesine (Lilly/EG Labo; not available in the U.S.), rituximab * (Genentech), and monoclonal anti-IL-6-antibody (multiple manufacturers) for post-transplant lymphoproliferative disorder (PTLD) (clinical trial); vincristine * (Lilly/Gensia Sicor) and bleomycin * (Bristol-Myers Squibb) for PTLD and Kaposi's sarcoma (KS); liposomal daunorubicin (Gilead) for KS (indicated for HIV-associated KS); paclitaxel (BristolMyers Squibb) for KS (indicated for AIDS-associated KS); imatinib (Novartis) and bevacizumab (Genentech) for KS; and matrix metalloproteinase inhibitor COL-3 (CollaGenex) for KS (clinical trial). ( * Drugs marked with asterisks are indicated for use in malignant lymphomas generally, but no specific mention is made of PTLD.)The content of this article has been reviewed by independent peer reviewers to ensure that it is balanced, objective, and free from commercial bias. No financial relationships relevant to the content of this article have been disclosed by the authors, planners, independent peer reviewers, or staff managers. LEARNING OBJECTIVESAfter completing this course, the reader should be able to:1. Describe the most common malignancies encountered after solid organ transplantation.2. Discuss the pathogenesis of malignancy after solid organ transplantation. Administer standard treatment for common post-solid organ transplantation malignancies.This article is available for continuing medical education credit at CME.TheOncologist.com. CME CME ABSTRACT CASE PRESENTATIONA 49-year-old man with no prior medical history initially presented with severe dyspnea progressive over 6 months.The patient underwent an open-lung biopsy that confirmed the diagnosis of idiopathic pulmonary fibrosis. He was assessed for lung transplantation. An extensive pretransplant

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Quantitative EBV Viral Loads and Immunosuppression Alterations can Decrease PTLD Incidence in Pediatric Liver Transplant Recipients

Cited by 236 publications

References 24 publications

EBV-Associated Lymphoproliferative Disorders: Classification and Treatment

EBV-Associated Lymphoproliferative Disorders: Classification and Treatment

Canadian Cardiovascular Society Consensus Conference update on cardiac transplantation 2008: Executive Summary

Malignancy After Solid Organ Transplantation: An Overview

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