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Clémentine Sarkozy, Sophie Kaltenbach, Pierre Faurie, Danielle Canioni, Françoise Berger, Alexandra Traverse-Glehen, Hervé Ghesquieres, Gilles Salles, Emmanuel Bachy, Marie-Alexandra Alyanakian, Olivier Hermine, Bénédicte Neven, Elizabeth Macintyre, Serge Romana, Thierry Jo Molina, Felipe Suarez, Vahid Asnafi, Julie Bruneau
Plasma-cell post-transplantation lymphoproliferative disorder (PC-PTLD) is a rare monomorphic PTLD entity divided into plasma cell myeloma (PCM) and plasmacytoma-like lesion (PLL) PTLD. To date, there are no exhaustive published cytogenetic data on PC-PTLD. We report array-based comparative genomic hybridization (aCGH) of 10 cases of PCM and PLL-PTLD. Patients had received kidney (n=6), heart (n=2), lung (n=1) or bone marrow (n=1) transplantation. There were six men and median age at time of PTLD was 56.5 years (3-74)...
October 17, 2016: Genes, Chromosomes & Cancer
Tasneem Kaleem, Jennifer A Crozier, David M Menke, Taimur Sher
Post-transplant lymphoproliferative disorders (PTLD) are a serious complication of transplantation with a high mortality. Most PTLD present within the first year of transplantation and are associated with Epstein-Barr virus (EBV) infection. Plasmablastic lymphoma (PBL) is a rare but aggressive disease originally described in patients with HIV, presenting most commonly in the jaw and oral mucosa. To our knowledge, this is the first case of PBL presenting as PTLD of the lung in a HIV and EBV negative patient...
September 5, 2016: Rare Tumors
Satona Tanaka, Toyofumi F Chen-Yoshikawa, Kyoko Hijiya, Masatsugu Hamaji, Hideki Motoyama, Akihiko Aoyama, Hiroshi Date
Patients after lung transplantation are at risk for postoperative malignancy mainly due to postoperative immunosuppression. Skin cancer and post-transplant lymphoproliferative disorder (PTLD) are common in Western countries. We retrospectively reviewed the medical records of 120 patients undergoing lung transplantation between April 2002 and July 2015 at Kyoto University. Postoperative malignancy developed in 14 patients(11.7%):PTLD in 8, gastric cancer in 2, breast cancer in 1, glioblastoma in 1, lung cancer in 1, and adenocarcinoma of unknown primary in 1...
October 2016: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Mihaja Raberahona, Chloe Wackenheim, Raphaele Germi, Martin Carré, Claude-Eric Bulabois, Anne Thiébaut, Julien Lupo, Touyana Semenova, Jean-Yves Cahn, Patrice Morand, Olivier Epaulard
BACKGROUND: Epstein-Barr virus (EBV) displays oncogenic properties, particularly in the immunocompromised host. Notably, hematopoietic stem cell transplantation (HSCT) recipients with a detectable blood EBV viral load (BEBVL) are considered at higher risk of post-transplant lymphoproliferative diseases (PTLD). Therefore, BEBVL is monitored after HSCT, and preemptive rituximab may be used in patients with high values. However, little is known about post-HSCT BEBVL dynamics, and the threshold that should lead to anti-CD20 therapy is poorly defined...
October 1, 2016: Transplant Infectious Disease: An Official Journal of the Transplantation Society
L Cavicchioli, S Ferraresso, S Westmoreland, S Kaliyaperumal, H Knight, C Crossan, L Scobie, A Danesi, M Vadori, D Trez, R Aron Badin, P Hantraye, E Cozzi
Posttransplant lymphoproliferative disorders (PTLDs) are a heterogeneous group of lymphoid proliferations that occur in the setting of depressed T-cell function due to immunosuppressive therapy used following solid organ transplantation, hematopoietic stem cell transplantation, and also xenotransplantation. In the present study, 28 immunosuppressed parkinsonian Macaca fascicularis were intracerebrally injected with wild-type or CTLA4-Ig transgenic porcine xenografts to identify a suitable strategy to enable long-term cell survival, maturation, and differentiation...
September 30, 2016: Veterinary 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
Julie Morscio, Thomas Tousseyn
Post-transplant lymphoproliferative disorder (PTLD) is an aggressive complication of solid organ and hematopoietic stem cell transplantation that arises in up to 20% of transplant recipients. Infection or reactivation of the Epstein-Barr virus (EBV), a ubiquitous human herpesvirus, in combination with chronic immunosuppression are considered as the main predisposing factors, however insight in PTLD biology is fragmentary. The study of PTLD is complicated by its morphological heterogeneity and the lack of prospective trials, which also impede treatment optimization...
September 24, 2016: World Journal of Transplantation
Ilan Maizlin, David A Klima, Elizabeth A Beierle
Posttransplant lymphoproliferative disorder (PTLD) is not uncommon in pediatrics. This case report describes a case of intestinal intussusception that occurred secondary to lymphoid hyperplasia in a child with PTLD following a cardiac transplant. This case was unique in its presentation with multiple areas of intussusception and with need for surgical intervention. The diagnosis of intussusception secondary to lead points from PTLD should be strongly considered in pediatric transplant patients presenting with abdominal complaints...
September 2016: American Surgeon
Thomas Schachtner, Maik Stein, Petra Reinke
The number of kidney transplant recipients (KTRs) after nonrenal solid organ transplantation (SOT) has increased to almost 5%. Knowledge on patient and allograft outcomes, infections, and alloreactivity, however, remains scarce. We studied 40 KTRs after nonrenal SOT. 720 primary KTRs and 119 repeat KTRs were used for comparison. Samples were collected pretransplantation, at +1, +2, and +3 months posttransplantation. Alloreactive and CMV-specific T-cells were measured by interferon-γ Elispot assay. Patient survival in KTRs after SOT, primary and repeat KTRs was comparable...
September 17, 2016: Transplant International: Official Journal of the European Society for Organ Transplantation
Miao Lu, Julie Ho, Nazila Azordegan, Anamarija M Perry, Ian W Gibson, Patricia Baker
Voided urine is routinely collected from renal transplant patients to screen for polyomavirus. In rare cases, atypical lymphoid cells can be detected in voided urine and raise the suspicion of post-transplant lymphoproliferative disorder (PTLD). However, further immunohistochemistry of the cell block and flow cytometry is frequently limited by the low cellularity and poor preservation of voided urine. Therefore, PTLD of the renal allograft is usually diagnosed from tissue biopsy or nephrectomy specimens. Herein, we report a rare case of atypical cells in a voided urine cytology specimen from a kidney transplant recipient...
September 16, 2016: Diagnostic Cytopathology
T Schachtner, P Reinke
BACKGROUND: Because of the strikingly increased risk of post-transplant lymphoproliferative disorder (PTLD) in Epstein-Barr virus (EBV)-seronegative kidney transplant recipients (KTRs) from EBV-seropositive donors - EBV(D(+) R(-) ), special strategies need to be defined to prevent EBV transmission and EBV viremia. METHODS: We studied all KTRs at our center between 2008 and 2012. Seventeen of 402 KTRs (4.2%) were identified as EBV(D(+) R(-) ), among which 5 KTRs received kidneys from living donors and 12 KTRs from deceased donors...
September 15, 2016: Transplant Infectious Disease: An Official Journal of the Transplantation Society
Emily Milford, Caroline Winslow, Rebecca Danhof
Posttransplantation lymphoproliferative disorder (PTLD) is a rare complication of solid organ or allogenic bone marrow transplantation. Cases localized to the skin are even rarer, with only around 100 cases recorded in the literature [2]. We present a case of 60 year-old-woman, a lung transplant recipient, who presented with an asymptomatic violaceous nodule on her left medial calf. Histopathology was consistent with PTLD of the B-cell subtype, EBV negative. This case is unique in that it was of the B cell subtype of cutaneous PTLD, which has been less commonly observed than the T cell subtype...
2016: Dermatology Online Journal
L Song, A Ma, H Dun, Y Hu, Y Fujii, F Kinugasa, S Oshima, Y Higashi, P Daloze, H Chen
Belatacept is the first costimulatory blockade agent approved for maintenance immunosuppression in kidney transplant recipients. Clinical results have indicated that belatacept is associated with superior renal function and improved metabolic profile. However, higher incidence of acute rejection and PTLD are the shortcomings of this agent. In this study, ASP2409, a new CTLA4-Ig possessing 14-fold higher in vitro CD86 binding affinity than belatacept, was tested for renal allograft survival in cynomolgus monkeys...
September 6, 2016: American Journal of Transplantation
I García-Cadenas, I Rivera, R Martino, A Esquirol, P Barba, S Novelli, G Orti, J Briones, S Brunet, D Valcarcel, J Sierra
This study aimed to characterize the incidence, etiology and outcome of infectious episodes in patients with steroid refractory acute GvHD (SR-GvHD). The cohort included 127 adults treated with inolimomab (77%) or etanercept (23%) owing to acute 2-4 SR-GvHD, with a response rate of 43% on day +30 and a 4-year survival of 15%. The 1-year cumulative incidences of bacterial, CMV and invasive fungal infection were 74%, 65% and 14%, respectively. A high rate (37%) of enterococcal infections was observed. Twenty patients (15...
September 5, 2016: Bone Marrow Transplantation
Mirjana Trukalj, Marija Perica, Željko Ferenčić, Damir Erceg, Marta Navratil, Gzim Redžepi, Boro Nogalo
BACKGROUND Pulmonary alveolar proteinosis (PAP) is a rare condition characterized by the intra-alveolar accumulation of surfactant-derived material, which impairs gas exchange and results in respiratory insufficiency. Two major subtypes of PAP are autoimmune and non-autoimmune PAP. The diagnosis relies on clinical presentation, ground glass opacities on CT scan, bronchoscopy with PAS stain of BAL fluid (BALF), lung biopsy with PAS-positive material in the alveoli, and the presence of anti GM-CSF antibodies in serum or BALF for an autoimmune subtype...
2016: American Journal of Case Reports
Jamie Koo, David W Dawson, Sarah Dry, Samuel W French, Bita V Naini, Hanlin L Wang
In this study, we sought to determine the incidence of posttransplant complications including acute cellular rejection (ACR), infection, and posttransplant lymphoproliferative disease (PTLD) in mucosal allograft biopsies in patients with small bowel transplant at our institution. We retrospectively reviewed pathology reports from 5675 small bowel allograft biopsies from 99 patients and analyzed the following: indications for biopsy, frequency and grade of ACR, presence of infectious agents, results of work-up for potential PTLD, results of C4d immunohistochemistry (IHC), features of chronic mucosal injury, and findings in concurrent native bowel biopsies...
September 1, 2016: Clinical Transplantation
R Trusson, J E Serre, I Szwarc, V Brunot, V Garrigue, S Delmas, T Kanouni, G Cartron, G Mourad
Posttransplantation lymphoproliferative disorder (PTLD) after solid organ transplantation may carry a poorer prognosis than lymphoma in immunocompetent individuals, but comparative data are lacking. In a retrospective, single-center, case-control study, 21 cases of PTLD were identified in patients undergoing kidney transplantation since 2000, and compared to 42 nontransplanted controls cared for in the same institution and matched for age, prognostic index, and cerebral localization. Two-year and 5-year overall survival was 57% and 44%, respectively, in PTLD patients and 71% and 58% in controls (log-rank test P = ...
July 2016: Transplantation Proceedings
Akira Satou, Akio Kohno, Ryuichi Fukuyama, Ahmed Ali Elsayed, Shigeo Nakamura
Epstein-Barr virus (EBV)-positive mucocutaneous ulcer (EBVMCU) is a newly described entity occurring in elderly or iatrogenically immunocompromised patients. We describe a case of EBVMCU arising in a post-hematopoietic cell transplant patient, and followed by EBV-positive polymorphic post-transplant lymphoproliferative disorder (EBV(+) polymorphic PTLD). The patient, a 52-year-old woman, received chemotherapy and autologous peripheral blood stem cell transplantation (auto-PBSCT) for relapsed diffuse large B-cell lymphoma (DLBCL)...
August 25, 2016: Human Pathology
Selma Alagoz, Serkan Feyyaz Yalin, Sibel Gulcicek, Nurgul Ozgur, Mehmet Riza Altiparmak, Nurhan Seyahi
Posttransplant lymphoproliferative disorder (PTLD) is one of the most common malignancies after kidney transplantation. Different clinical and histopathological forms of PTLD related to immunosuppression can be observed after organ transplantations. We report a 42-year-old woman who had undergone deceased donor renal transplantation with an unusual presentation of PTLD. The immunosuppressive treatment was discontinued and appropriate chemotherapy was started. However, the patient died despite this treatment...
August 22, 2016: Progress in Transplantation
Johan W de Fijter
Malignancy is the second most common single cause of death observed in organ transplant recipients. The excess cancer risk is related to intensity and duration of immunosuppressive therapy and inversely to recipient age. Immunodeficiency and (chronic/oncogenic) viral infections together constitute a major risk. Nonmelanoma skin cancer, Kaposi sarcoma and posttransplant lymphoproliferative disease (PTLD) have standardized incidence ratios exceeding 10- or 50-fold. The mammalian target of rapamycin (mTOR) inhibitors, sirolimus and everolimus, are increasingly used after organ transplantation with potential advantages in virus-associated post-transplant malignancies as well as anti-cancer properties...
August 10, 2016: Transplantation
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