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https://www.readbyqxmd.com/read/28340951/epstein-barr-virus-hemophagocytic-lymphohistiocytosis-related-to-rituximab-use-and-immunopathogenetic-insights
#1
Sotirios G Papageorgiou, Sotirios Tsiodras, Georgios Siakallis, Efthimia Bazani, Aris Spathis, Garyfalia Poulakou, Penelope Korkolopoulou, Ioannis Panayiotides, Vasiliki Pappa
Anti-CD20-based chemo-immunotherapeutic regimens have been suggested to assist in the management of Epstein-Barr virus (EBV)-induced hemophagocytic lymphohistiocytosis (HLH) and EBV-associated post-transplant lymphoproliferative disorders (EBV-PTLD), by reducing EBV viral load and EBV-induced inflammation. Herein we report a fatal EBV-related HLH in the context of Hodgkin lymphoma (HL)-like Richter's transformation of B chronic lymphocytic leukemia (B-CLL), two months after rituximab treatment. The complex balance between EBV driven T-cell stimulation and immunosuppressive therapy in the context of multiple immune deficits is discussed...
December 2016: Pathology, Research and Practice
https://www.readbyqxmd.com/read/28317077/de-novo-cancer-in-patients-on-dialysis-and-after-renal-transplantation-north-western-italy-1997-2012
#2
Valentina Mazzucotelli, Pierluca Piselli, Diana Verdirosi, Claudia Cimaglia, Giovanni Cancarini, Diego Serraino, Silvio Sandrini
BACKGROUND: Kidney transplant recipients (KTR) are known to have a higher risk of cancer than the general population, especially of malignancies related to oncogenic viral infections. This study assessed the incidence of de novo malignancies (DNMs) in patients receiving kidney transplantation and in dialysis patients (DP) on the waiting list for transplantation at the same centre. The aim was to quantify the contribution of post-transplant immunosuppression to the underlying risk of developing a DNM in dialysis patients on the waiting list for kidney transplant...
March 19, 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/28316846/donor-derived-smoldering-multiple-myeloma-following-a-hematopoietic-cell-transplantation-for-aml
#3
Bita Fakhri, Mark Fiala, Michael Slade, Peter Westervelt, Armin Ghobadi
Posttransplant Lymphoproliferative Disorder (PTLD) is one of the most common malignancies complicating solid organ transplantation. In contrast, PTLD accounts for a minority of secondary cancers following allogeneic hematopoietic cell transplantation (HCT). Here we report on a 61-year-old woman who received an ABO-mismatched, HLA-matched unrelated donor hematopoietic cell transplantation from a presumably healthy donor for a diagnosis of acute myeloid leukemia (AML). Eighteen months following her transplant, she developed a monoclonal gammopathy...
2017: Case Reports in Hematology
https://www.readbyqxmd.com/read/28316109/airway-inflammation-and-symptoms-in-children-following-liver-and-heart-transplantation
#4
Andrew J Redmann, John C Bucuvalas, Robert E Wood, Clifford Chin, Catherine K Hart
OBJECTIVES: Describe the upper airway endoscopic findings of children with upper airway symptoms after liver transplantation (LT) or heart transplantation (HT). METHODS: Review of children undergoing airway endoscopy after LT or HT from 2011 to 2015 at a tertiary care pediatric hospital. Airway findings, biopsy results, immunosuppression and Ebstein Barr virus (EBV) levels were recorded. RESULTS: Twenty-three of 158 LT (111) and HT (47) recipients underwent endoscopy...
March 18, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28295657/severe-acute-cellular-rejection-after-intestinal-transplantation-is-associated-with-poor-patient-and-graft-survival
#5
Genevieve Huard, Thomas D Schiano, Jang Moon, Kishore Iyer
BACKGROUND: Severe acute cellular rejection (ACR) occurs frequently after intestinal transplantation (ITx). AIM: To evaluate the outcomes and the risk factors for graft failure and mortality in patients with severe ACR after ITx. METHODS: Retrospective study evaluating all ITx recipients who developed severe ACR between 01/2000 and 07/2014. Demographic and histologic data were reviewed. RESULTS: 20/126 (15.9%) ITx recipients developed severe ACR...
March 10, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28280938/viral-load-of-ebv-dnaemia-is-a-predictor-of-ebv-related-post-transplant-lymphoproliferative-disorders-in-pediatric-renal-transplant-recipients
#6
Elisa Colombini, Isabella Guzzo, Federica Morolli, Germana Longo, Cristina Russo, Alessandra Lombardi, Pietro Merli, Luisa Barzon, Luisa Murer, Simone Piga, Marta Luisa Ciofi Degli Atti, Franco Locatelli, Luca Dello Strologo
BACKGROUND: Post-transplant lymphoproliferative disorder (PTLD) is a severe complication of solid organ transplantation that can be classified into two major subtypes, namely, early lesions and non-early lesions, based on histopathological findings. In the vast majority of cases, proliferating cells are B lymphocytes and, most frequently, proliferation is induced by Epstein-Barr virus (EBV) infection. METHODS: The aim of our study was to evaluate the natural history of EBV infection and its possible evolution toward PTLD in a pediatric cohort of patients who received a renal transplant between January 2000 and December 2013...
March 9, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28275302/post-transplant-lymphoproliferative-disorder-after-liver-transplantation-incidence-long-term-survival-and-impact-of-serum-tacrolimus-level
#7
Ahad Eshraghian, Mohammad Hadi Imanieh, Seyed Mohsen Dehghani, Saman Nikeghbalian, Alireza Shamsaeefar, Frouzan Barshans, Kourosh Kazemi, Bita Geramizadeh, Seyed Ali Malek-Hosseini
AIM: To investigate incidence and survival of post-transplant lymphoproliferative disorder (PTLD) patients after liver transplantation. METHODS: A cross-sectional survey was conducted among patients who underwent liver transplantation at Shiraz Transplant Center (Shiraz, Iran) between August 2004 and March 2015. Clinical and laboratory data of patients were collected using a data gathering form. RESULTS: There were 40 cases of PTLD in the pediatric age group and 13 cases in the adult group...
February 21, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28272287/risk-factors-and-outcomes-of-de-novo-cancers-excluding-nonmelanoma-skin-cancer-after-liver-transplantation-for-primary-sclerosing-cholangitis
#8
Mohamad A Mouchli, Siddharth Singh, Edward V Loftus, Lisa Boardman, Jayant Talwalkar, Charles B Rosen, Julie K Heimbach, Russell H Wiesner, Bashar Hasan, John J Poterucha, Kymberly D Watt
BACKGROUND: Patients with primary sclerosing cholangitis (PSC) may be at higher of risk of malignancy after liver transplantation (LT) compared to other LT recipients. We aimed to determine the cumulative incidence of/risk factors for and long-term cancer-related mortality in patients with PSC after LT. METHODS: All adult patients who underwent LT for PSC without cholangiocarcinoma from 1984-2012, with follow-up through June 2015. We estimated cumulative incidence, risk factors and mortality from de novo malignancies after LT RESULTS: 293 patients were identified (mean age, 47±12 years; 63...
March 8, 2017: Transplantation
https://www.readbyqxmd.com/read/28265581/impact-of-desensitization-on-antiviral-immunity-in-hla-sensitized-kidney-transplant-recipients
#9
Mieko Toyoda, Bong-Ha Shin, Shili Ge, James Mirocha, David Thomas, Maggie Chu, Edgar Rodriguez, Christine Chao, Anna Petrosyan, Odette A Galera, Ashley Vo, Jua Choi, Alice Peng, Joseph Kahwaji, Stanley C Jordan
Viral infections represent significant morbidity and mortality factors in kidney transplant recipients, with CMV, EBV, and BKV infections being most common. Desensitization (DES) with IVIg and rituximab with/without plasma exchange followed by kidney transplantation with alemtuzumab induction increased successful transplant rates in HLA-sensitized patients but may represent an increased risk for viral infections due to severe lymphocyte depletion. Here, we report on the posttransplant viral infection status in 372 DES versus 538 non-DES patients...
2017: Journal of Immunology Research
https://www.readbyqxmd.com/read/28191298/asymptomatic-epstein-barr-virus-shedding-in-the-urine-of-kidney-transplant-recipients-case-reports-and-review-of-the-literature
#10
Maryam Rahbar, Gholamreza Poormand, Masoud Karkhaneh Mahmoodi, Aboozar Jazayeri, Seyed Mohammad Jazayeri
Epstein-Barr virus (EBV) is associated with a wide range of malignancies and complications like post-transplant lymphoproliferative disorder (PTLD). To suppress active EBV infection in transplant recipients, who are at a heightened risk of developing PTLD, EBV DNAemia monitoring has been recommended. Quantitative multiplex real time polymerase chain reaction (QMRTPCR) offered the advantage of detection of more than one target in the same sample. We present four cases of kidney transplant recipient who were admitted for rising serum creatinine between 9 and 20 months post-transplant with a suspicion of BKV-associated nephropathy...
December 31, 2016: Infectious Disease Reports
https://www.readbyqxmd.com/read/28167270/free-light-chain-and-intact-immunoglobulin-abnormalities-in-heart-transplant-recipients-two-year-follow-up-timelines-and-clinical-correlations
#11
Peter Sečník, Petra Lavríková, Lenka Hošková, Pavlína Malíková, Antonín Jabor, Janka Franeková
OBJECTIVES: To assess the timelines of serum free light chain (sFLC) concentrations and the kappa/lambda light chain (K/L) ratio in heart transplant (HTX) recipients. To analyze the performance of serum protein electrophoresis (SPE), serum immunofixation (sIFE) and sFLC measurements for gammopathy detection following a HTX. METHODS: A total of 96 patients who underwent a HTX were analyzed during a two-year follow-up period. The relevant clinical data were obtained from patient medical records...
February 4, 2017: Transplant Immunology
https://www.readbyqxmd.com/read/28116196/a-rare-presentation-of-isolated-cns-posttransplantation-lymphoproliferative-disorder
#12
Jaime Morris, Casey Smith, Andrew Streicher, Allison Magnuson, Susan Newman, Robert Bertoli
Posttransplantation lymphoproliferative disorder (PTLD) is a recognized and extremely morbid complication of solid organ transplantation, but central nervous system involvement, particularly in isolation, is rare. There are no standardized treatment strategies for PTLD, though commonly used strategies include reduction of immunosuppression, chemotherapy, rituximab, radiation, and surgery. We present a case of an unusual morphologic variant of primary central nervous system PTLD with successful response to rituximab and cranial radiation...
2017: Case Reports in Oncological Medicine
https://www.readbyqxmd.com/read/28089555/epstein-barr-virus-and-renal-transplantation
#13
REVIEW
Jade Le, Christine M Durand, Irfan Agha, Daniel C Brennan
Epstein-Barr virus (EBV) is a gamma herpesvirus associated with diseases ranging from asymptomatic viremia to post-transplant malignancies in kidney transplant recipients. EBV specifically is associated with post-transplantation lymphoproliferative disorder (PTLD), in kidney transplant recipients, with increased risk in EBV seronegative patients with EBV seropositive donors on intensified immunosuppression. The diagnosis of PTLD relies on clinical suspicion plus tissue biopsy with polymerase chain reaction (PCR) testing of blood currently used for risk determination in high-risk recipients...
January 2017: Transplantation Reviews
https://www.readbyqxmd.com/read/28073178/polyclonal-and-monoclonal-antibodies-for-induction-therapy-in-kidney-transplant-recipients
#14
REVIEW
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
https://www.readbyqxmd.com/read/28066999/transplant-infectious-diseases-a-review-of-the-scientific-registry-of-transplant-recipients-published-data
#15
REVIEW
C N Kotton, S Huprikar, D Kumar
The Scientific Registry of Transplant Recipients (SRTR) serves to collect data on organ transplants performed in the United States. Although the infectious diseases data are limited and include mostly pretransplant serologies and other nonspecific infection-related outcomes, this multicenter data collection allows for insightful national data and the ability to monitor trends over time. We reviewed the published concise reports for each organ type in SRTR reports containing data from 2005 to 2014, and summarized our findings with respect to cytomegalovirus (CMV), Epstein-Barr virus, posttransplant lymphoproliferative disorder (PTLD), hepatitis B virus (HBV), hepatitis C virus (HCV), HIV, general infection, and prophylaxis...
January 9, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28058224/persistent-epstein-barr-viral-load-in-epstein-barr-viral-na%C3%A3-ve-pediatric-heart-transplant-recipients-risk-of-late-onset-post-transplant-lymphoproliferative-disease
#16
Bibhuti Das, Robert Morrow, Rong Huang, David Fixler
AIM: To examine the risk of late-onset post-transplant lymphoproliferative disorder (PTLD) in the presence of persisting high Epstein-Barr virus (EBV) in EBV naïve pediatric heart transplant (HT) recipients. METHODS: A retrospective review of the medical records of the 145 pediatric HT recipients who had serial EBV viral load monitoring at our center was performed. We defined EBV naive patients whose EBV serology either IgM or IgG in the blood were negative at the time of HT and excluded passive transmission from mother to child in subjects less than 6 mo of age...
December 24, 2016: World Journal of Transplantation
https://www.readbyqxmd.com/read/28052685/occurrence-of-malignancies-after-kidney-transplantation-in-adults-slovak-multicenter-experience
#17
Z Zilinska, M Sersenova, M Chrastina, J Breza, L Bena, T Baltesova, A Jurcina, R Roland, E Lackova, M Cellar, L Laca, I Dedinska
Malignancies are one of the three major causes of renal recipient´s death with a functioning graft after cardiovascular diseases and infections. Among the variety of risk factors, including conventional and specific to transplant recipients, the duration of immunosuppressive therapy, the intensity of therapy, and the type of immunosuppressive agent all have an impact on development of post-transplant malignancy. The aim of our retrospective study was to document the incidence, the type of malignancies, the patient/graft survival in the group of kidney transplant recipients in Slovak Republic, and to identify the factors which influenced the outcome...
2017: Neoplasma
https://www.readbyqxmd.com/read/28039929/epstein-barr-virus-dna-monitoring-in-serum-and-whole-blood-in-pediatric-liver-transplant-recipients-who-do-or-do-not-discontinue-immunosuppressive-therapy
#18
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
https://www.readbyqxmd.com/read/28039080/risk-factors-for-and-the-clinical-impact-of-cytomegalovirus-and-epstein-barr-virus-infections-in-pediatric-recipients-of-tcr-%C3%AE-%C3%AE-and-cd19-depleted-grafts
#19
Alexandra Laberko, Anna Bogoyavlenskaya, Larisa Shelikhova, Zhanna Shekhovtsova, Dmitriy Balashov, Kirill Voronin, Elena Kurnikova, Elena Boyakova, Elena Raykina, Varvara Brilliantova, Valentina Pirumova, Galina Novichkova, Alexei Maschan, Michael Maschan
Alpha/beta T cell and CD19 depletion are used to improve the outcomes of hematopoietic stem cell transplantation (HSCT). We evaluated the burden of cytomegalovirus (CMV) and Epstein-Barr virus (EBV) in pediatric patients after this HSCT type. A cohort of 182 patients with malignant (n = 114) or nonmalignant (n = 68) disorders was transplanted from either matched unrelated (n = 124) or haploidentical (n = 58) donors. The cumulative incidence of CMV and EBV viremia were 51% and 33%, respectively...
March 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28035754/sinusoidal-cd30-diffuse-large-b-cell-lymphoma-can-masquerade-as-anaplastic-large-cell-lymphoma-in-pediatric-posttransplant-lymphoproliferative-disorders
#20
Neel S Bhatt, Michael E Kelly, Bjorn Batdorf, Gabriela Gheorghe
Posttransplant lymphoproliferative disorder (PTLD) is a known complication of solid organ transplantation. Diffuse large B-cell lymphoma (DLBCL) is frequently seen in this setting. However, CD30+ DLBCL with sinusoidal pattern of involvement has not been reported in pediatric PTLD. We are reporting a 9-year-old female child presented with diffuse lymphadenopathy postheart transplantation. The pattern of involvement was suggestive of anaplastic large cell lymphoma, but the malignant cells were positive for B-cell markers and negative for anaplastic lymphoma kinase...
December 30, 2016: Pediatric Blood & Cancer
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