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Post transplant lymphoproliferative disease

Céline Habre, Paola M Soccal, Frédéric Triponez, John-David Aubert, Thorsten Krueger, Steve P Martin, Joanna Gariani, Jean-Claude Pache, Frédéric Lador, Xavier Montet, Anne-Lise Hachulla
Complications following lung transplantation may impede allograft function and threaten patient survival. The five main complications after lung transplantation are primary graft dysfunction, post-surgical complications, alloimmune responses, infections, and malignancy. Primary graft dysfunction, a transient ischemic/reperfusion injury, appears as a pulmonary edema in almost every patient during the first three days post-surgery. Post-surgical dysfunction could be depicted on computed tomography (CT), such as bronchial anastomosis dehiscence, bronchial stenosis and bronchomalacia, pulmonary artery stenosis, and size mismatch...
August 15, 2018: Insights Into Imaging
Samantha Correia, Ray Bridges, Fanny Wegner, Cristina Venturini, Anne Palser, Jaap M Middeldorp, Jeffrey I Cohen, Mario A Lorenzetti, Irene Bassano, Robert E White, Paul Kellam, Judith Breuer, Paul J Farrell
138 new Epstein-Barr virus (EBV) genome sequences have been determined. 125 of these and 116 from previous reports were combined to produce a multiple sequence alignment of 241 EBV genomes, which we have used to analyze variation within the viral genome. The type 1/type2 classification of EBV remains the major form of variation and is defined mostly by EBNA2 and EBNA3, but the type 2 SNPs at the EBNA3 locus extend into the adjacent gp350 and gp42 genes, whose products mediate infection of B cells by EBV. A small insertion within the BART miRNA region of the genome was present in 21 EBV strains...
August 15, 2018: Journal of Virology
Bruno Roque Lima, Caroline Correa de Tulio Augusto Roque, Maria Dirlei Begnami, Patricia Peresi, Eduardo Nobrega Pereira Lima, Celso Abdon Lopes de Mello, Felipe José Fernandez Coimbra, Rubens Chojniak, Tiago Goss Santos
Liver metastasis is the major cause of death for patients with colorectal cancer. Despite treatment with surgery and chemotherapy, patient outcomes are quite unfavorable. Thus, there is an urgent need to develop new treatment strategies with the associated establishment of good animal models. Metastatic disease can be modeled using patient-derived orthotopic xenografts, which accurately replicate intra-tumoral heterogeneity, so that various chemotherapeutic agents can be tested on individual tumors to aid in clinical decision-making...
August 8, 2018: Journal of Drug Targeting
Yasodha Natkunam, Dita Gratzinger, Amy Chadburn, John R Goodlad, John K C Chan, Jonathan Said, Elaine S Jaffe, Daphne de Jong
Immunodeficiency-associated lymphoproliferative disorders (IA-LPDs) are pathologically and clinically heterogeneous. In many instances, similar features are shared by a spectrum of IA-LPDs in clinically diverse settings. The World Health Organization (WHO), however, classifies IA-LPDs by their immunodeficiency setting largely according to the paradigm of post-transplant lymphoproliferative disorders (PTLD), but with inconsistent terminology and disease definitions. The field currently lacks standardization and would greatly benefit from thinking across immunodeficiency categories by adopting a common working vocabulary to better understand these disorders and guide clinical management...
August 6, 2018: Blood
O Mazanowska, P Donizy, J Kuźmińska, K Roczek, A Zimny, M Banasik, D Kaminska, K Hap, M Klinger, A Halon
INTRODUCTION: Acute central nervous system (CNS) damage in a patient who has received organ transplant is an extremely difficult and complex clinical issue that spans a wide spectrum of differential diagnoses with ischemia, post-transplant lymphoproliferative disorders (PTLDs), infections, lymphomas, and progressive multifocal leukoencephalopathy (PML). PTLDs are a clinically and histopathologically heterogeneous group of diseases that most often occur in heavily immunocompromised populations after solid organ transplantation (SOT), probably related to the infection or reactivation of Epstein-Barr virus (EBV) infection, whereas PML is an infectious disease caused by the John Cunningham virus (JCV)...
July 2018: Transplantation Proceedings
Thomas S Rogers, Laura McGevna, Deborah L Cook
Post-transplant lymphoproliferative disease (PTLD) is a rare lymphoid and/or plasmacytic proliferation that occurs in the context of immunosuppression due to solid organ transplantation (SOT) and allogeneic hematopoietic stem cell transplantation (HSCT). PTLD is the most common cancer in children who receive a SOT or HSCT, occurring in up to 13% of these patients. The majority of PTLDs are extracutaneous B-cell lymphomas with only 12-14% representing the T-cell phenotype. PTLDs can involve the skin and behave like an aggressive lymphoma, and are among the most serious and potentially fatal complications of transplantation...
July 27, 2018: Journal of Cutaneous Pathology
Masaaki Hotta, Aya Nakaya, Shinya Fujita, Atsushi Satake, Takahisa Nakanishi, Yoshiko Azuma, Yukie Tsubokura, Akiko Konishi, Hideaki Yoshimura, Tomoki Ito, Kazuyoshi Ishii, Shosaku Nomura
Post-transplant lymphoproliferative disorder (PTLD) is a well-recognized complication of organ transplantation. Progress has recently been made in the pathological classification of PTLD. However, the clinical course has not been clarified because of the rarity of this disease. We experienced a case of PTLD with a fulminant clinical course. The patient had been under longterm immunosuppressive treatment for aplastic anemia. He received related allogeneic hematopoietic stem cell transplantation. Soon after transplantation, he developed PTLD...
May 14, 2018: Hematology Reports
Arjun Datt Law, Maria Queralt Salas, Wilson Lam, Fotios V Michelis, Santhosh Thyagu, Dennis Dong Hwan Kim, Jeffrey Howard Lipton, Rajat Kumar, Hans Messner, Auro Viswabandya
BACKGROUND: Haploidentical hematopoietic stem cell transplantation (haploSCT) with conditioning regimens using post-transplant cyclophosphamide (PTCy) for peripheral blood stem cell (PBSC) grafts is limited by comparably higher rates of acute and chronic graft-versus-host disease (GVHD). Anti-thymocyte globulin (ATG) may mitigate this risk. We evaluated haploSCT after reduced intensity conditioning (RIC) with ATG, PTCy & cyclosporine to prevent rejection and GVHD. METHODS: Fifty adults underwent haploSCT from August 2016-February 2018...
July 12, 2018: Biology of Blood and Marrow Transplantation
Bo-Kyoung Park, Hyo-Sup Kim, Seongkoo Kim, Jae-Wook Lee, Young Shil Park, Pil-Sang Jang, Nack-Gyun Chung, Dae-Chul Jeong, Bin Cho
Background: Allogeneic hematopoietic stem cell transplantation (HSCT) is a curative therapy for β-thalassemia major (TM) and sickle cell disease (SCD) in children. Graft-versus-host disease (GVHD) and treatment-related mortality (TRM) remain significant challenges to improving survival after HSCT. Here, we analyzed the outcome of TM and SCD patients, who received allogeneic HSCT with myeloablative conditioning at our institution. Methods: Twenty-two patients (15 TM, 7 SCD), with a median age of 9 years (range, 1...
June 2018: Blood Research
Yuhua Ru, Jia Chen, Depei Wu
Epstein-Barr virus (EBV) viremia and post-transplant lymphoproliferative disease (PTLD) are severe complications after hematopoietic stem cell transplantation (HSCT). A series of risk factors have been found to predict EBV viremia and PTLD, including the T-cell depletion, reduced intensity conditioning, and alternative donor. The rituximab pre-emptive therapy could improve PTLD prognosis significantly, but the trigger of initiating rituximab pre-emptive therapy has not been well established. Additionally, EBV-specific cytotoxic T cell (CTL) is a promising approach to treat EBV-PTLD...
June 27, 2018: European Journal of Haematology
Joseph S Pagano, Christopher B Whitehurst, Graciela Andrei
Epstein⁻Barr virus (EBV) infects up to 95% of the adult human population, with primary infection typically occurring during childhood and usually asymptomatic. However, EBV can cause infectious mononucleosis in approximately 35⁻50% cases when infection occurs during adolescence and early adulthood. Epstein⁻Barr virus is also associated with several B-cell malignancies including Burkitt lymphoma, Hodgkin lymphoma, and post-transplant lymphoproliferative disease. A number of antiviral drugs have proven to be effective inhibitors of EBV replication, yet have resulted in limited success clinically, and none of them has been approved for treatment of EBV infections...
June 13, 2018: Cancers
Laura J Wozniak, Tian L Mauer, Robert S Venick, Jonathan W Said, Roy L Kao, Pamela Kempert, Elizabeth A Marcus, Vilayphone Hwang, Elaine Y Cheng, Ronald W Busuttil, Sue V McDiarmid, Douglas G Farmer
Post-transplant lymphoproliferative disease (PTLD) has the highest incidence following intestinal transplantation (ITx). Our center has seen a recent increase in PTLD. Our aim was to review a single-center PTLD experience with a focus on clinical characteristics and outcomes. We completed a retrospective review of biopsy-proven PTLD cases using a prospectively maintained database of 115 ITx recipients transplanted between 1991 and 2014. Nineteen (17%) ITx recipients developed 25 PTLD cases during a median follow-up time of 6...
June 11, 2018: Clinical Transplantation
Ravish Parekh, Ahmed Abdulhamid, Sheri Trudeau, Nirmal Kaur
Background: Outcome data regarding the use of tumor necrosis factor alpha inhibitors (anti-TNF α ) in patients with inflammatory bowel disease (IBD) after liver transplant (LT) for primary sclerosing cholangitis (PSC) are scant. Methods: We performed a retrospective chart review to investigate outcomes among a series of post-liver-transplant PSC/IBD patients receiving anti-TNF α therapy at Henry Ford Health System ((HFHS), Detroit, MI). Results: A total of five patients were treated with anti-TNF α agents for IBD after LT for PSC from 1993 through 2015...
2018: Case Reports in Gastrointestinal Medicine
G Narayan, R Jha, P Srikant, S Sinha, G Swarnalata, K V V N Raju
Renal transplant recipients are at a higher risk of malignancy. We report our experience and the critical differences in the presentation of malignancy in kidney transplant patients performed at our tertiary care center and followed up over the period of 1990-2015. A total of 338 live donor transplants performed in 332 patients were analyzed. Induction immunosuppression was used in 22 cases with interleukin-2 (IL-2) receptor antibody. Overall 299 patients were continued on calcineurin inhibitor (CNI)-based triple drug immunosuppression, 33 were off CNI with 13 of them receiving sirolimus additionally...
March 2018: Indian Journal of Nephrology
Neval E Wareham, Amanda Mocroft, Henrik Sengeløv, Caspar Da Cunha-Bang, Finn Gustafsson, Carsten Heilmann, Martin Iversen, Nikolai S Kirkby, Allan Rasmussen, Søren Schwartz Sørensen, Jens D Lundgren
PURPOSE: Emerging EBV DNAemia in plasma is considered an early sign of post-transplant lymphoproliferative disorder (PTLD). The aim of this study was to quantify the extent of benefit from screening for EBV DNAemia to detect emerging PTLD among solid organ (SOT) or hematopoietic stem cell transplant recipients (HSCT). METHODS: We used receiver operating characteristic (ROC) curves for assessing ability of models to predict PTLD. Among 2642 recipients transplanted between January 2004 and December 2014, 79 (3%) developed PTLD...
August 2018: Journal of Cancer Research and Clinical Oncology
Ajay Major, Manali Kamdar
Post-transplant lymphoproliferative disorder (PTLD) is one of the most common neoplasms seen after solid organ and hematopoietic stem cell transplantation, and is associated with significant morbidity and mortality. The pathogenesis is related to post-transplant immunosuppression and EBV infection. Prevention of PTLD depends upon judicious use of immunosuppression and serial EBV monitoring. Preemptive therapy consists of reduction of immunosuppression, antiviral medications, and single-agent rituximab. There are no randomized phase III trials on PTLD treatment, so current management guidelines are largely based on recent phase II trials, single-institution retrospective studies, and expert opinion...
May 24, 2018: Current Treatment Options in Oncology
Bashir Hakim, Daniel T Myers, Todd R Williams, Shunji Nagai, John Bonnett
Intestinal transplant (IT) is one of the least common forms of organ transplant but is increasing both in volume of cases and number of centers performing intestinal transplants, with the busiest centers in North America and Europe. IT can be performed in isolation or as part of a multivisceral transplant (MVT). Intestinal failure either in the form of short gut syndrome or functional bowel problems is the primary indication for IT. The normal post-surgical anatomy can be variable due to both recipient anatomy in regard to amount of residual bowel and status of native vasculature as well as whether the transplant is isolated or part of a multivisceral transplant...
June 5, 2018: British Journal of Radiology
Lukas Marcelis, Charlien Berghen, Alexandra De Zutter, Pauline Biesemans, Peter Vandenberghe, Gregor Verhoef, Olivier Gheysens, Xavier Sagaert, Daan Dierickx, Thomas Tousseyn
Ongoing development of new drugs, as well as novel indications in the treatment of autoimmune diseases leads to the increasing use of immunomodulatory and immunosuppressive drugs. Immunomodulatory agent-related lymphoproliferative disorders are a known and potentially life threatening complication of chronic administration of these drugs, but are less well characterized compared with post-transplant lymphoproliferative disorders. The heterogeneous drug targets, various underlying disease indications, different drug combinations used and relatively low incidence render data collection and interpretation difficult...
May 15, 2018: Modern Pathology: An Official Journal of the United States and Canadian Academy of Pathology, Inc
F Fabbian, A De Giorgi, R Tiseo, R Cappadona, B Zucchi, M Rubbini, F Signani, A Storari, R De Giorgio, G La Manna, R Manfredini
OBJECTIVE: The aim of this retrospective study was to investigate the relationship between cancer, non-immunologic comorbidity, estimated by International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codification, gender and in-hospital mortality (IHM) in a large sample of renal transplant recipients (RTRs) living in the region Emilia-Romagna (RER) of Italy. PATIENTS AND METHODS: We evaluated IHM in RTRs admitted between 2000 and 2013 recorded in the RER database...
April 2018: European Review for Medical and Pharmacological Sciences
Thanh-Phuong Afiat, Xiaohui Zhang, Hailing Zhang, Ernesto Ayala, Ling Zhang, Lubomir Sokol
Posttransplant lymphoproliferative disorders (PTLDs) of T-cell orgin are rare biologically heterogeneous diseases of mature lymphoid cells manifesting in immunosuppressed patients. Only a few cases of mycosis fungoides diagnosed post allogeneic hematopoietic cell transplant (alloHSCT) have been described so far. We present a patient with myelodysplastic syndrome (MDS) post matched unrelated donor alloHSCT who was on long-term immunosuppressive therapy due to graft versus host disease. Three years after an alloHSCT, she developed generalized erythroderma and peripheral blood lymphocytosis...
2018: Leukemia Research Reports
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