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https://www.readbyqxmd.com/read/28535360/posttransplant-lymphoproliferative-disorder-otolaryngological-manifestations-and-management
#1
Richard Heyes, Donald W Northfelt, David G Lott
Objective Posttransplant lymphoproliferative disorder (PTLD) is a unifying term for a spectrum of lymphoid expansion entities brought about by immunosuppression and is strongly associated with Epstein-Barr virus (EBV). Otolaryngological findings tend to present early in the clinical course; therefore, disease awareness among otolaryngologists is of utmost importance. This review synthesizes the body of literature pertaining to PTLD involving the head and neck, summarizes contemporary management, and highlights areas for future research...
May 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28513810/epstein-barr-virus-encephalitis-in-solid-organ-transplantation
#2
Jillian S Y S Y, Zhi Mei Low, Iain Abbott, Lani Shochet, John Kanellis, Richard A Kitching, Tony M Korman
Epstein-Barr virus (EBV) is typically associated with post transplant lymphoproliferative disease (PTLD) after solid organ and stem cell transplantation. However, it is rarely associated with neurological complications. We report a case of severe encephalitis complicating primary EBV infection six months post renal transplantation, and review the literature on EBV encephalitis in solid organ transplantation in adults. A 55-year-old male presented 6 months post cadaveric renal transplant with headache, fever and confusion...
May 17, 2017: New Microbiologica
https://www.readbyqxmd.com/read/28509395/da-epoch-r-for-post-transplant-lymphoproliferative-disorders-ptld
#3
Christin B DeStefano, Vera Malkovska, Hind Rafei, Aarthi Shenoy, Kelly Fitzpatrick, Anita Aggarwal, Joseph P Catlett
Post-transplant lymphoproliferative disorders (PTLD) are a heterogeneous and potentially fatal group of neoplasms arising in an immunodeficient environment in the background of viral antigenic stimulation. PTLD is rare, with an incidence in solid organ transplant recipients typically less than 20% [1]. For aggressive, monomorphic cases, current guidelines recommend reduced immunosuppression in addition to chemoimmunotherapy, which generally consists of R-CHOP [1]. Nevertheless, prognosis is poor with 5-year overall survival (OS) rates of only 40-60% [1]...
May 16, 2017: European Journal of Haematology
https://www.readbyqxmd.com/read/28508661/post-transplant-lymphoproliferative-disease-in-liver-transplant-recipients
#4
Mercedes Rubio-Manzanares Dorado, José María Álamo Martínez, Carmen Bernal Bellido, Luis Miguel Marín Gómez, Gonzalo Suárez Artacho, Carmen Cepeda Franco, Jize Wang, Miguel Ángel Gómez Bravo, Francisco Javier Padillo
INTRODUCTION: Post-transplant lymphoproliferative syndrome (PTLD) is a rare and potentially life-threatening complication after liver transplantation. The aim of this study was to analyze the clinicopathologic features related to PTLD in a single institution after liver transplantation. METHODS: Observational study where we have retrospectively analyzed 851 cases who underwent liver transplantation. Ten cases have developed PTLD. Their clinical-pathological characteristics and the treatment received have been analyzed...
May 16, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28499936/ucbt-without-antithymocyte-globulin-results-in-similar-survival-but-better-quality-of-life-compared-with-upbsct-for-the-treatment-of-acute-leukemia-a-retrospective-study-in-china
#5
J Tong, L Xuan, Y L Sun, D P Huang, H L Liu, C C Zheng, X Y Zhu, B L Tang, K D Song, X H Zhang, L Zhang, W Yao, D J Lin, Q F Liu, Z M Sun
While previous studies have demonstrated improved outcomes in umbilical cord blood transplantation (UCBT) by omitting antithymocyte globulin (ATG) in the conditioning regimen, this approach has not been comparatively studied in unrelated peripheral blood stem cell transplantation (UPBSCT). To compare the risks and benefits between UCBT without ATG and UPBSCT in patients with acute leukemia (AL). This was a multicenter retrospective study of 79 patients who underwent UCBT (myeloablative conditioning without ATG) and 96 patients who underwent UPBSCT (myeloablative conditioning with ATG)...
May 9, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28493355/consideration-of-difficulties-and-exit-strategies-in-a-case-of-face-allotransplantation-resulting-in-failure
#6
Özlenen Özkan, Ömer Özkan, Umuttan Doğan, Vural Taner Yılmaz, Hilmi Uysal, Levent Ündar, Ebru Apaydın Doğan, Ozan Salim, Anı Çinpolat, Atilla Ramazanoglu
We describe the first rescue procedure in a case of total face allotransplantation. The recipient was a 54-year-old man with severe disfigurement of the entire face following an accidental gunshot injury 5 years previously. The large defect included the maxilla, mandible, and mid-face. Full face procurement was performed from a multiorgan cadaveric donor and was allotransplanted to the recipient. The post-transplant induction immunosuppressive regimen included ATG combined with tacrolimus, mycophenolate mofetil, and prednisone, while maintenance was provided by the last three of these...
May 11, 2017: Microsurgery
https://www.readbyqxmd.com/read/28489256/clinical-and-virologic-outcomes-in-high-risk-adult-ebv-mismatched-organ-transplant-recipients
#7
Deepali Kumar, Nikhil Patil, Shahid Husain, Cecilia Chaparro, Mamatha Bhat, S Joseph Kim, Atul Humar
EBV D+/R- organ transplant recipients are a high-risk group for developing PTLD. Little data are available for prevention in the adult EBV mismatched population. We conducted a retrospective study of EBV D+/R- organ transplants performed during 2002-2014. Of the 153 patients identified, 82.4% patients received antiviral prophylaxis with valganciclovir for a median of 4.5 months (range 0.8-22 months) and 36.6% underwent viral load monitoring in the first post-transplant year. EBV viremia developed in 67.2% monitored patients...
May 10, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28487787/ebv-negative-monomorphic-b-cell-posttransplant-lymphoproliferative-disorder-with-marked-morphologic-pleomorphism-and-pathogenic-mutations-in-asxl1-bcor-cdkn2a-nf1-and-tp53
#8
Agata M Bogusz
Posttransplant lymphoproliferative disorders (PTLDs) are a diverse group of lymphoid or plasmacytic proliferations frequently driven by Epstein-Barr virus (EBV). EBV-negative PTLDs appear to represent a distinct entity. This report describes an unusual case of a 33-year-old woman that developed a monomorphic EBV-negative PTLD consistent with diffuse large B-cell lymphoma (DLBCL) 13 years after heart-lung transplant. Histological examination revealed marked pleomorphism of the malignant cells including nodular areas reminiscent of classical Hodgkin lymphoma (cHL) with abundant large, bizarre Hodgkin-like cells...
2017: Case Reports in Hematology
https://www.readbyqxmd.com/read/28465118/development-and-validation-of-a-major-adverse-transplant-event-mate-score-to-predict-late-graft-loss-in-pediatric-heart-transplantation
#9
Christopher S Almond, Helena Hoen, Joseph W Rossano, Chesney Castleberry, Scott R Auerbach, Lingyao Yang, Ashwin K Lal, Melanie D Everitt, Matthew Fenton, Seth A Hollander, Elfriede Pahl, Elizabeth Pruitt, David N Rosenthal, Doff B McElhinney, Kevin P Daly, Manisha Desai
BACKGROUND: There is inadequate power to perform a valid clinical trial in pediatric heart transplantation (HT) using a conventional end-point, because the disease is rare and hard end-points, such as death or graft loss, are infrequent. We sought to develop and validate a surrogate end-point involving the cumulative burden of post-transplant complications to predict death/graft loss to power a randomized clinical trial of maintenance immunosuppression in pediatric HT. METHODS: Pediatric Heart Transplant Study (PHTS) data were used to identify all children who underwent an isolated orthotopic HT between 2005 and 2014 who survived to 6 months post-HT...
March 24, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28456611/increased-risk-of-ptld-in-lung-transplant-recipients-with-cystic-fibrosis
#10
Erin M Lowery, William Adams, Shellee A Grim, Nina M Clark, Leah Edwards, Jennifer E Layden
BACKGROUND: Post-transplant lymphoproliferative disease (PTLD) is an important cause of morbidity and mortality following lung transplantation. Recipients with cystic fibrosis (CF) may have an increased risk of PTLD although the literature is limited to single center cohorts. Our primary aim is to examine PTLD in an adult lung transplant population by utilizing the International Society for Heart and Lung Transplantation Registry. METHODS: We studied 30,598 adult recipients of lung transplants performed between 1999 and 2011...
April 26, 2017: Journal of Cystic Fibrosis: Official Journal of the European Cystic Fibrosis Society
https://www.readbyqxmd.com/read/28447098/application-of-natural-language-processing-and-network-analysis-techniques-to-post-market-reports-for-the-evaluation-of-dose-related-anti-thymocyte-globulin-safety-patterns
#11
Taxiarchis Botsis, Matthew Foster, Nina Arya, Kory Kreimeyer, Abhishek Pandey, Deepa Arya
OBJECTIVE: To evaluate the feasibility of automated dose and adverse event information retrieval in supporting the identification of safety patterns. METHODS: We extracted all rabbit Anti-Thymocyte Globulin (rATG) reports submitted to the United States Food and Drug Administration Adverse Event Reporting System (FAERS) from the product's initial licensure in April 16, 1984 through February 8, 2016. We processed the narratives using the Medication Extraction (MedEx) and the Event-based Text-mining of Health Electronic Records (ETHER) systems and retrieved the appropriate medication, clinical, and temporal information...
April 26, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28432802/subsequent-malignancies-after-allogeneic-hematopoietic-stem-cell-transplantation
#12
Mehmet Gündüz, Mehmet Özen, Uğur Şahin, Selami Koçak Toprak, Sinem Civriz Bozdağ, Meltem Kurt Yüksel, Önder Arslan, Muhit Özcan, Taner Demirer, Meral Beksaç, Osman İlhan, Günhan Gürman, Pervin Topçuoğlu
We evaluated 979 patients for the development of post-transplant lymphoproliferative disease (PTLD) and solid malignancies after allogeneic hematopoietic stem cell transplantations (allo-HSCT) as a late complication. We found 15 (1.5%) subsequent malignancies; three of these malignancies were PTLD, and twelve were solid tumors. The median time from allo-HSCT to the development of PTLD was 9 (3-20) months and that from allo-HSCT to the development of solid tumors was 93 (6-316) months. The cumulative incidence of evolving subsequent malignancy in patients was 1...
April 22, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28419429/mutational-landscape-of-b-cell-post-transplant-lymphoproliferative-disorders
#13
Thomas Menter, Darius Juskevicius, Mary Alikian, Juerg Steiger, Stephan Dirnhofer, Alexandar Tzankov, Kikkeri N Naresh
It is currently unclear whether post-transplant diffuse large B-cell lymphomas (PT-DLBCL) display a similar genomic landscape as DLBCL in immunocompetent patients (IC-DLBCL). We investigated 50 post-transplant lymphoproliferative disorders (PTLDs) including 37 PT-DLBCL samples for somatic mutations frequently observed in IC-DLBCL. Targeted Next Generation Sequencing (NGS) using the Ion Torrent platform and a customized panel of 68 genes was performed on genomic DNA. Non-tumoural tissue was sequenced to exclude germline variants in cases where available...
April 17, 2017: British Journal of Haematology
https://www.readbyqxmd.com/read/28392824/posttransplantation-lymphoproliferative-disorder-after-pediatric-solid-organ-transplantation-experiences-of-20-years-in-a-single-center
#14
Hyung Joo Jeong, Yo Han Ahn, Eujin Park, Youngrok Choi, Nam-Joon Yi, Jae Sung Ko, Sang Il Min, Jong Won Ha, Il-Soo Ha, Hae Il Cheong, Hee Gyung Kang
PURPOSE: To evaluate the clinical spectrum of posttransplantation lymphoproliferative disorder (PTLD) after solid organ transplantation (SOT) in children. METHODS: We retrospectively reviewed the medical records of 18 patients with PTLD who underwent liver (LT) or kidney transplantation (KT) between January 1995 and December 2014 in Seoul National University Children's Hospital. RESULTS: Eighteen patients (3.9% of pediatric SOTs; LT:KT, 11:7; male to female, 9:9) were diagnosed as having PTLD over the last 2 decades (4...
March 2017: Korean Journal of Pediatrics
https://www.readbyqxmd.com/read/28390107/post-transplant-lymphoproliferative-disorder-following-clinical-islet-transplantation-report-of-the-first-two-cases
#15
Anthea Peters, Tolu Olateju, Jean Deschenes, Santosh H Shankarnarayan, Neil Chua, A M James Shapiro, Peter Senior
We report the first two cases of post-transplant lymphoproliferative disorder (PTLD) in recipients of islet transplants worldwide. First, a 44-year old recipient of 3 islet infusions developed PTLD 80 months after his initial transplant, presenting with abdominal pain and diffuse terminal ileum thickening on imaging. He was treated with surgical excision, reduction of immunosuppression and rituximab. Seven months later he developed central nervous system PTLD, presenting with vertigo and diplopia; immunosuppression was discontinued, resulting in graft loss, and he was given high-dose methotrexate and consolidative autologous stem cell transplant...
April 8, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28383790/post-transplant-lymphoproliferative-disease-in-lung-transplantation-a-nested-case-control-study
#16
Annelies Leyssens, Daan Dierickx, Eric K Verbeken, Thomas Tousseyn, Stijn E Verleden, Bart M Vanaudenaerde, Lieven J Dupont, Jonas Yserbyt, Geert M Verleden, Dirk E Van Raemdonck, Robin Vos
Post-transplant lymphoproliferative disorder (PTLD) may compromise long-term outcome of lung transplant (LTx) recipients. A case-control study was performed, comparing LTx recipients with PTLD (n=31) to matched recipients without PTLD (Controls, n=62). Risk factors for PTLD and post-transplant outcomes were assessed. PTLD prevalence was 3.9%, time to PTLD 323 (166-1132) days; and 54.8% had early-onset PTLD versus 45.2% late-onset PTLD. At LTx, more Epstein-Barr virus (EBV)-seronegative patients were present in PTLD (42%) compared to Controls (5%) (P<...
April 6, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28378408/cancer-recurrence-and-mortality-after-pediatric-heart-transplantation-for-anthracycline-cardiomyopathy-a-report-from-the-pediatric-heart-transplant-study-phts-group
#17
Matthew J Bock, Elfriede Pahl, Paolo G Rusconi, Gerard J Boyle, John J Parent, Clare J Twist, James K Kirklin, Elizabeth Pruitt, Daniel Bernstein
We aimed to determine whether malignancy after pediatric HTx for ACM affects overall post-HTx survival. Patients <18y listed for HTx for ACM in the PHTS database between 1993 and 2014 were compared to those with DCM. A 2:1 matched DCM cohort was also compared. Wait-list and post-HTx survival, along with freedom from common HTx complications, were compared. Eighty subjects were listed due to ACM, whereas 1985 were listed for DCM. Although wait-list survival was higher in the ACM group, post-HTx survival was lower for the ACM cohort...
April 4, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28376031/the-immune-response-to-epstein-barr-virus-and-implications-for-posttransplant-lymphoproliferative-disorder
#18
Olivia M Martinez, Sheri M Krams
Posttransplant lymphoproliferative disorder (PTLD) is a serious complication in organ transplant recipients and is most often associated with the Epstein Barr virus (EBV). EBV is a common gammaherpes virus with tropism for B lymphocytes and infection in immunocompetent individuals is typically asymptomatic and benign. However, infection in immunocompromised or immunosuppressed individuals can result in malignant B cell lymphoproliferations such as PTLD. EBV+ PTLD can arise following primary EBV infection, or because of reactivation of a prior infection, and represents a leading malignancy in the transplant population...
April 4, 2017: Transplantation
https://www.readbyqxmd.com/read/28367350/immune-reconstitution-inflammatory-syndrome-occurring-in-a-kidney-transplant-patient-with-extrapulmonary-tuberculosis
#19
Jose Iglesias, Kandria Jumil Ledesma, Paul J Couto, Jessie Liu
Tuberculosis (TB) occurring in solid organ transplantation (SOT) is associated with significant morbidity and mortality usually due to delays in diagnosis, drug toxicity encountered with antimycobacterial therapy, and drug-drug interactions. TB in SOT patients may mimic other infectious and noninfectious posttransplant complications such as posttransplant lymphoproliferative disorder (PTLD) and systemic cytomegalovirus infection. Immune reconstitution inflammatory syndrome (IRIS) is a host response resulting in paradoxical worsening of an infectious disease which occurs after the employment of effective therapy and reversal of an immunosuppressed state...
2017: Case Reports in Transplantation
https://www.readbyqxmd.com/read/28357549/fdg-uptake-in-cervical-lymph-nodes-in-children-without-head-and-neck-cancer
#20
Reza Vali, Alaa A Bakari, Eman Marie, Mahnaz Kousha, Martin Charron, Amer Shammas
BACKGROUND: Reactive cervical lymphadenopathy is common in children and may demonstrate increased (18)F-fluoro-deoxyglucose ((18)F-FDG) uptake on positron emission tomography/computed tomography (PET/CT). OBJECTIVE: We sought to evaluate the frequency and significance of (18)F-FDG uptake by neck lymph nodes in children with no history of head and neck cancer. MATERIALS AND METHODS: The charts of 244 patients (114 female, mean age: 10.4 years) with a variety of tumors such as lymphoma and post-transplant lymphoproliferative diseases (PTLD), but no head and neck cancers, who had undergone (18)F-FDG PET/CT were reviewed retrospectively...
March 29, 2017: Pediatric Radiology
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