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Ptld children

Penny Hill, Nicholas B Cross, A Nicholas R Barnett, Suetonia C Palmer, Angela C Webster
BACKGROUND: Prolonging kidney transplant survival is an important clinical priority. Induction immunosuppression with antibody therapy is recommended at transplantation and non-depleting interleukin-2 receptor monoclonal antibodies (IL2Ra) are considered first line. It is suggested that recipients at high risk of rejection should receive lymphocyte-depleting antibodies but the relative benefits and harms of the available agents are uncertain. OBJECTIVES: We aimed to: evaluate the relative and absolute effects of different antibody preparations (except IL2Ra) when used as induction therapy in kidney transplant recipients; determine how the benefits and adverse events vary for each antibody preparation; determine how the benefits and harms vary for different formulations of antibody preparation; and determine whether the benefits and harms vary in specific subgroups of recipients (e...
January 11, 2017: Cochrane Database of Systematic Reviews
C Kullberg-Lindh, R Saalman, M Olausson, G Herlenius, M Lindh
The rate of PTLD can be reduced by weaned IS guided by monitoring of EBV DNA. In this single-center retrospective case series study, we analyzed how reduction in IS influenced EBV DNA levels in whole blood and serum in 30 children during the first year after liver transplantation, and how these levels were related to symptoms putatively due to EBV. Primary and reactivated EBV infection was seen in 18 (60%) and eight patients (27%), respectively. Thirteen patients (42%) developed chronic high load the first year post-transplant...
December 31, 2016: Pediatric Transplantation
Rebecca L King, Michele E Paessler, Matthew T Howard, Gerald B Wertheim
AIMS: To examine the need for minimal diagnostic criteria for post-transplant lymphoproliferative disorders (PTLD) in children, we sought to determine the rate of incidental Epstein-Barr virus (EBV)-positivity in tissues from organ transplant recipients (OTR). METHODS: EBV in situ hybridisation (ISH) was done retrospectively on tissue from 34 paediatric autopsies of OTR and paediatric tonsillectomy specimens from non-OTR (96) and OTR (6). Patients with a history of PTLD were excluded from both data sets...
November 15, 2016: Journal of Clinical Pathology
Johanna Kampers, Manuela Orjuela-Grimm, Tilmann Schober, Thomas F Schulz, Martina Stiefel, Christoph Klein, Dieter Körholz, Christine Mauz-Körholz, Hans Kreipe, Rita Beier, Britta Maecker-Kolhoff
Post-transplant lymphoproliferative disease (PTLD) is a severe complication after solid organ transplantation (SOT). Classical Hodgkin lymphoma-type (HL-) PTLD is a rare subtype, and systematic data on treatment and prognosis are lacking. We report on 17 pediatric patients with classical HL-PTLD. HL-PTLD developed late at a median of 8.1 years after SOT. It was commonly EBV-positive (16/17) and expressed both CD30 (all tumors) and CD20 (8/17 tumors). Patients were treated with chemotherapy +/- involved field radiotherapy (IF-RT) according to the respective GPOH-HD protocol tailored by stage and LDH...
August 11, 2016: Leukemia & Lymphoma
María Dolores Fellner, Karina A Durand, Veronica Solernou, Andrea Bosaleh, Ziomara Balbarrey, María T García de Dávila, Marcelo Rodríguez, Lucía Irazu, Lidia V Alonio, María A Picconi
High levels of circulating EBV load are used as a marker of post-transplant lymphoproliferative disorders (PTLD). There is no consensus regarding the threshold level indicative of an increase in peripheral EBV DNA. The aim of the study was to clinically validate a developed EBV quantification assay for early PTLD detection. Transversal study: paired peripheral blood mononuclear cells (PBMC), plasma and oropharyngeal lymphoid tissue (OLT) from children undergoing a solid organ transplant with (n=58) and without (n=47) PTLD...
April 2016: Revista Argentina de Microbiología
A Malone, G Kennedy, L Storey, A O'Marcaigh, M McDermott, A M Broderick, O P Smith
BACKGROUND: Post-transplant lymphoproliferative disease (PTLD) is a serious complication of both solid organ and haematopoietic stem cell transplantation in children. Its incidence has increased over the last decade as a result of more potent immunosuppressive regimens. Many treatments have been explored however optimal therapy remains controversial. AIMS: We report on the diagnosis, treatment and outcome of ten patients who were diagnosed with PTLD in Our Lady's Hospital for Sick Children in Dublin between 2004 and 2015 inclusive...
February 29, 2016: Irish Journal of Medical Science
A Keshtkari, S M Dehghani, M Haghighat, M H Imanieh, A Nasimfard, G Yousefi, H Javaherizadeh
Post-transplantation lymphoproliferative disorder (PTLD) is a serious complication of solid organ transplantation that occurs due to immunosuppression and other risk factors. PTLD may present with involvement of other organs and with unusual presentation. The presentation is often extranodal (e.g., in the gastrointestinal tract, lung, or the central nervous system). Herein, we report on a 1.5-year-old girl who underwent liver transplantation almost 5 months prior to admission. She was on medications such as tacrolimus and prednisolone...
2016: International Journal of Organ Transplantation Medicine
Tang-Her Jaing, Chieh-Tsai Wu, Shih-Hsiang Chen, Yu-Chuan Wen, Tsung-Yen Chang, Wen-Yu Chuang
We report 4 pediatric cases of biopsy-proven posttransplant lymphoproliferative disorder (PTLD) in the context of allogeneic hematopoietic stem cell transplantation (HSCT). All cases showed diffuse staining with latent membrane protein-1 in immunohistochemistry. The median age at transplant of 4 patients with PTLD was 10.1 years (range, 2.2 to 13.2 y). The median interval between HSCT and the diagnosis of PTLD was 5.5 months (range, 4 to 8 mo). All patients were treated with rituximab at dosage of 375 mg/m at weekly intervals...
April 2016: Journal of Pediatric Hematology/oncology
Steven C Greenway, Ryan Butts, David C Naftel, Elizabeth Pruitt, James K Kirklin, Ingrid Larsen, Simon Urschel, Kenneth Knecht, Yuk Law
BACKGROUND: Although used routinely, the pleiotropic benefits of statins remain understudied in children after heart transplantation. We hypothesized that statin therapy would reduce the incidence of rejection, cardiac allograft vasculopathy (CAV) and post-transplant lymphoproliferative disease (PTLD). METHODS: This study was a retrospective review of 964 pediatric (ages 5 to 18 years) heart transplant recipients in the multicenter Pediatric Heart Transplant Study registry from 2001 to 2012...
April 2016: Journal of Heart and Lung Transplantation
Eugenia Giraldi, Massimo Provenzi, Valentino Conter, Michele Colledan, Stefania Bolognini, Carlo Foglia, Roberta Sebastiani, Roberto Fiocchi, Andrea Gianatti, Lorenzo DʼAntiga, Alessandro Rambaldi
BACKGROUND: Optimal management of posttransplant lymphoproliferative disease (PTLD) remains to be defined due to heterogeneity of this condition and lack of predictors of the outcome. Here we report our experience with pediatric PTLD nonresponsive to immunosuppression (IS) withdrawal, managed after stratification into high and low risk according to the presenting features. METHODS: This is a single-center retrospective review of prospectively enrolled patients. From 2001 to 2011, 17 children were diagnosed with severe B-lineage, CD20+, PTLD after a median of 37 months (range, 5-93) from liver (12), heart (4), or multiorgan (1) transplantation...
February 2016: Transplantation
Don Hayes, Christopher K Breuer, Edwin M Horwitz, Andrew R Yates, Joseph D Tobias, Toshiharu Shinoka
The influence of posttransplant lymphoproliferative disorder (PTLD) on long-term survival in children after heart transplantation (HTx) is not well studied. The United Network for Organ Sharing database was queried from 1987 to 2013 for data on PTLD in relation to induction immunosuppression and recipient Epstein-Barr virus status in children (<18 years of age) who underwent HTx. Of 6818 first-time pediatric heart transplants, 5169 had follow-up data on posttransplant malignancy, with 360 being diagnosed with PTLD...
December 2015: Pediatric Cardiology
Rachel Becker-Cohen, Efrat Ben-Shalom, Choni Rinat, Sofia Feinstein, Michael Geylis, Yaacov Frishberg
BACKGROUND: Infections are an important cause of morbidity and mortality in solid organ transplant recipients. Neutrophils play a crucial role in the initial host defense against bacterial pathogens. Neutropenia is not uncommon after renal transplantation in adults; however, there are scarce published data in children. We conducted a historical cohort study to evaluate the incidence, clinical course, and management of severe neutropenia after renal transplantation in children. METHODS: In a single-center study, we collected clinical and laboratory data on all children (<20 years) who underwent renal transplantation from January 2005 to March 2014...
November 2015: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Anastasia L Hryhorczuk, Heung Bae Kim, Marian H Harris, Sara O Vargas, David Zurakowski, Edward Y Lee
BACKGROUND: Multivisceral transplantation represents an important treatment option for children with intestinal failure. The attendant immunosuppression can lead to a spectrum of cellular proliferations including benign and malignant smooth muscle tumors and lymphoproliferative disorders, many related to cellular dysregulation from Epstein-Barr virus infection. OBJECTIVE: The purpose of this study is to investigate the rates of post-transplantation proliferative disorders among children with multivisceral transplantation and to characterize the imaging and pathological features of these disorders...
July 2015: Pediatric Radiology
Zhaohui Deng, Lirong Jiang, Tao Zhou, Conghuan Shen, Qimin Chen, Qiang Xia
OBJECTIVE: To summarize the clinical characteristics, early diagnosis, comprehensive treatment and prognosis of 6 cases of children with post-transplantation lymphoproliferative disorder (PTLD) after liver transplantation. METHOD: Data of 6 cases with PTLD seen between January 2011 and December 2013 were retrospectively analyzed. The anti-rejection drug dose adjustments, the effect of rituximab, antiviral therapy and comprehensive treatment program after surgery were explored...
August 2014: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
S V Beath, E Lanchbury, H Alton, R Mahandru, M Toy, I D van Mouirk, P J McKiernan, J Hartley, D A Kelly, K Sharif, G Gupte
INTRODUCTION: The terminal ileum (TI) is important for the active reabsorption of bile salts and is the site of allograft rejection; disruption of enterohepatic circulation (EHC) may give insights to inflammatory and other physiologic processes at the TI. SUBJECTS AND METHODS: Four children aged 5 to 12 years who had received small bowel transplantation (SBTx), 3 recovering from post-transplant lymphoproliferative disease (PTLD) and 1 with acute rejection, were studied...
July 2014: Transplantation Proceedings
Seung Beom Han, E Young Bae, Jae Wook Lee, Pil Sang Jang, Dong-Gun Lee, Nack-Gyun Chung, Dae Chul Jeong, Bin Cho, Soon Ju Lee, Jin Han Kang, Hack-Ki Kim
The present study was conducted to investigate Epstein-Barr virus (EBV) reactivation after hematopoietic cell transplantation (HCT) in Korean children living in an area of a high seroprevalence against EBV and to determine the impact of recipient age on EBV reactivation. Medical records of 248 children and adolescents who had received allogeneic HCT were retrospectively reviewed. The trends of EBV reactivation and post-transplant lymphoproliferative disorders (PTLDs) were evaluated and compared between younger (≤10 years old) and older (11-20 years old) groups...
August 2014: International Journal of Hematology
Angela Mensen, Il-Kang Na, Ralf Häfer, Astrid Meerbach, Maria Schlecht, Marie-Luise Pietschmann, Bernd Gruhn
PURPOSE: Rabbit antithymocyte globulin (ATG) is commonly used before allogeneic hematopoietic stem cell transplantation (allo-HSCT) to prevent graft-versus-host disease. Studies comparing the effect of different ATG preparations and dosages on immune reconstitution and risk for Epstein-Barr virus (EBV)-mediated post-transplant lymphoproliferative disorder (PTLD) are rare. METHODS: In this retrospective study, we determined T and B cell subsets by flow cytometry after allo-HSCT in children, who received ATG-Genzyme (ATG-G, n = 15), ATG-Fresenius (ATG-F, n = 25) or no-ATG treatment (n = 19)...
November 2014: Journal of Cancer Research and Clinical Oncology
Steven J Kindel, Brian F Joy, Elfriede Pahl, Eric L Wald
Although cardiac transplantation is life-saving, morbidities from immunosuppression are significant. EoE is a complication of calcineurin inhibitors following liver transplant causing feeding intolerance, weight loss, vomiting, and dysphagia. There are limited reports of EoE following heart transplantation. We performed a retrospective single-center review of pediatric cardiac transplant patients from 2000 to 2010. A case-control analysis of patients with and without EoE was performed evaluating heart transplantation outcomes such as rates of rejection, CAV, PTLD, and graft loss...
August 2014: Pediatric Transplantation
Brankica Spasojević-Dimitrijeva, Amira Peco-Antić, Dusan Paripović, Divna Kruscić, Zoran Krstić, Maja Cupić, Mirjana Cvetković, Gordana Milosevski-Lomić, Mirjana Kostić
INTRODUCTION: Post-transplant lymphoproliferative disorder (PTLD) is a heterogeneous group of diseases, characterized by abnormal lymphoid proliferation following transplantation. It is a disease of the immunosuppressed state, and its occurrence is mostly associated with the use of T-cell depleting agents, and also intensification of immunosuppressive regimens. In the majority of cases, PTLD is a consequence of Epstein-Barr virus (EBV) infection and is a B-cell hyperplasia with CD-20 positive lymphocytes...
January 2014: Srpski Arhiv za Celokupno Lekarstvo
R Karbasi-Afshar, S Taheri
Rituximab, an anti-CD20 agent, has been suggested as an effective strategy to deal with post transplant lymphoproliferative disorders (PTLD). In the current study, we aim to evaluate the efficacy of rituximab therapy in heart transplant population developing PTLD. A comprehensive search of the literature was performed to gather the available data on lymphoproliferative disorders occurring in heart transplant patients. Finally, data of 125 patients from 26 previously published studies were included into the study...
2013: Iranian Journal of Pediatric Hematology and Oncology
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