The diagnosis and treatment of posttransplant lymphoproliferative disorders

Nalesnik, Michael A.; Makowka, Leonard; Starzl, Thomas E.

doi:10.1016/0011-3840(88)90011-1

Cited by 238 publications

(114 citation statements)

References 187 publications

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“…For solid-organ transplant patients, these include: an EBV-seronegative recipient (especially with an EBV-seropositive donor), development of a primary EBV infection (or occasionally, reactivation of EBV) after transplant, high levels of immunosuppression (cyclosporine, tacrolimus, antithymocyte globulin, or antilymphocyte antibodies), presence of cytomegalovirus disease, and possibly younger age (independent of EBV status). 4,14 These factors manifest themselves as a higher risk of PTLD in patients with the most suppressed T-cell function. In solid-organ transplantation, pharmacologic immunosuppression is highest in lung transplant patients in whom the incidence of PTLD approaches 10%.…”

Section: Authormentioning

confidence: 99%

Post-transplant lymphoproliferative disorder: a review

Loren

Porter

Stadtmauer

et al. 2003

Bone Marrow Transplant

245

201

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Summary:Post-transplant lymphoproliferative disorder (PTLD) represents a spectrum of Epstein-Barr virus-related (EBV) clinical diseases, from a benign mononucleosis-like illness to a fulminant non-Hodgkin's lymphoma. In the setting of hematopoietic stem cell transplantation, PTLD is an often-fatal complication occurring relatively early after transplant. Risk factors for the development of PTLD are well established, and include HLA-mismatching, T-cell depletion, and the use of antilymphocyte antibodies as conditioning or treatment of graft-versushost disease. Early recognition of PTLD is particularly important in the SCT setting, because PTLD in these patients tends to be rapidly progressive. Familiarity with the clinical features of PTLD and a heightened level of suspicion are critical for making the diagnosis. Surveillance techniques with EBV antibody titers and/or polymerase chain raction (PCR) may have a role in some highrisk settings. Immune-based therapies such as monoclonal anti-B-cell antibodies, interferon-a, and EBV-specific donor T cells, either as treatment for PTLD or as prophylaxis in high-risk patients, represent promising new directions in the treatment of this disease.

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Section: Authormentioning

confidence: 99%

Post-transplant lymphoproliferative disorder: a review

Loren

Porter

Stadtmauer

et al. 2003

Bone Marrow Transplant

245

201

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“…Almost any tissue or organ can be affected, resulting in a wide array of clinical and radiologic presenta tions. Awarenessof the protean radiologic manifestations of this condition is important because it cansimulateotherdisease processes and because early detection may improve re sponse to therapy [2,3,5]. We reviewed imag ing studies of 60 patients with pathologically proven posttransplantation lymphoprolifera tive disorder who underwent solid organ trans plantation at our institution between 1988 and 1997.…”

Section: P Osttransplantationlymphoprolifermentioning

confidence: 99%

Abdominal manifestations of posttransplantation lymphoproliferative disorder.

Pickhardt¹,

Siegel²

1998

American Journal of Roentgenology

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“…A heightened risk for lymphoma has also been reported among patients receiving induction therapy with OKT3, especially beyond a threshold cumulative dose (6,9,12). It has been speculated that the intensity of immunosuppression, rather than any individual agent, is a key determinant of lymphoma formation (13,14), a conclusion supported by the higher incidence of lymphoma in recipients of nonrenal transplants, who receive higher doses of immunosuppression (6,15).…”

Section: Introductionmentioning

confidence: 99%

Lymphomas After Solid Organ Transplantation: A Collaborative Transplant Study Report

Opelz

Döhler

2004

American Journal of Transplantation

959

787

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We used the Collaborative Transplant Study database to analyze the incidence, risk, and impact of malignant lymphomas in approximately 200 000 organ transplant recipients. Over a 10-year period, the risk in renal transplant recipients was 11.8-fold higher than that in a matched nontransplanted population (p < < 0.0001). The majority of lymphomas were diagnosed after the first post-transplant year. Heart-lung transplants showed the highest relative risk (RR 239.5) among different types of organ transplants. In kidney recipients, immunosuppression with cyclosporine did not confer added risk compared with azathioprine/steroid treatment, whereas treatment with FK506 increased the risk approximately twofold. Induction therapy with OKT3 or ATG, but not with anti-IL2 receptor antibodies, increased the risk of lymphoma during the first year. Antirejection therapy with OKT3 or ATG also increased the risk. First-year mortality in renal and heart transplant patients with lymphoma was approximately 40% and 50%, respectively, and showed no improvement in recent years. A pattern of preferential localization to the vicinity of the transplant was noted, and the prognosis of the patient was related to localization. This study highlights the continuing risk for lymphoma with time post-transplantation, the contribution of immunosuppression to increased risk, and continuing poor outcomes in patients with post-transplant lymphoma.

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The diagnosis and treatment of posttransplant lymphoproliferative disorders

Cited by 238 publications

References 187 publications

Post-transplant lymphoproliferative disorder: a review

Post-transplant lymphoproliferative disorder: a review

Abdominal manifestations of posttransplantation lymphoproliferative disorder.

Lymphomas After Solid Organ Transplantation: A Collaborative Transplant Study Report

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