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https://www.readbyqxmd.com/read/29128025/posttransplant-lymphoproliferative-disorder-in-solid-organ-and-hematopoietic-stem-cell-transplantation
#1
REVIEW
Sarah J Nagle, Ran Reshef, Donald E Tsai
Posttransplant lymphoproliferative disorders (PTLD) represent an immunosuppression-related lymphoid or plasmacytic proliferation that occur in the setting of solid organ transplant or allogeneic hematopoietic stem cell transplantation (HSCT). PTLD is a devastating consequence of HSCT and solid organ transplantation with a high morbidity and mortality. Most commonly, PTLD is related to Epstein-Barr virus (EBV) infection, but an increasing number of non-EBV-related cases are occurring. Initial therapy involves withdrawal of immunosuppression with or without antibody or cytotoxic chemotherapy...
December 2017: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/29114932/risk-factors-for-post-transplant-lymphoproliferative-disorder-after-thymoglobulin-conditioned-hematopoietic-cell-transplantation
#2
Amit Kalra, Cameron Roessner, Jennifer Jupp, Tyler Williamson, Raymond Tellier, Ahsan Chaudhry, Faisal Khan, Minakshi Taparia, Victor H Jimenez-Zepeda, Douglas A Stewart, Andrew Daly, Jan Storek
Epstein-Barr virus (EBV)-induced post-transplant lymphoproliferative disorder (PTLD) occurs frequently when rabbit antithymocyte globulin (ATG) is used in hematopoietic cell transplant (HCT) conditioning. We retrospectively studied 554 patients undergoing ATG-conditioned myeloablative HCT. Strategies used to minimize mortality due to PTLD were either therapy of biopsy-diagnosed PTLD in the absence of EBV DNAemia monitoring (n=266) or prompt therapy of presumed PTLD (based on clinical/radiologic signs and high EBV DNAemia, in the setting of weekly EBV DNAemia monitoring) (n=199)...
November 8, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/29096390/epstein-barr-virus-dna-load-kinetics-analysis-in-allogeneic-hematopoietic-stem-cell-transplant-recipients-is-it-of-any-clinical-usefulness
#3
Carlos Solano, Eva María Mateo, Ariadna Pérez, Alberto Talaya, María José Terol, Eliseo Albert, Estela Giménez, Víctor Vinuesa, José Luis Piñana, Juan Carlos Hernández Boluda, David Navarro
BACKGROUND: There is a lack of clinical information regarding the usefulness of plasma Epstein-Barr virus (EBV) DNA load kinetics analyses in the management of EBV infections in allogeneic hematopoietic stem cell transplantation (allo-HSCT) recipients. Namely, it remains unknown whether this type of analysis can help physicians to anticipate the development of high-level EBV DNAemia episodes requiring rituximab treatment or predict the risk of recurrent EBV DNAemia or post-transplant lymphoproliferative disorders (PTLDs)...
October 27, 2017: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
https://www.readbyqxmd.com/read/29094407/a-retrospective-analysis-of-post-transplant-lymphoproliferative-disorder-following-liver-transplantation
#4
Feras Al Fararjeh, Shameem Mahmood, Phaedra Tachtatzis, Deborah Yallop, Stephen Devereux, Piers Patten, Kosh Agrawal, Abid Suddle, John O'Grady, Nigel Heaton, Robert Marcus, Shireen Kassam
OBJECTIVE: To evaluate response rates and survival in adults developing post-transplant lymphoproliferative disorder (PTLD) following liver transplantation METHODS: Patients were identified retrospectively and data collected through local liver and haematology electronic databases and pharmacy records. RESULTS: Forty-five patients were identified. The median age at first transplant and at development of PTLD was 48 and 54 years respectively, with the median time from transplant to PTLD diagnosis of 56 months...
November 1, 2017: European Journal of Haematology
https://www.readbyqxmd.com/read/29075059/monomorphic-post-transplant-lymphoproliferative-disorder-after-kidney-transplantation-and-hematopoietic-stem-cell-transplantation-clinicopathological-characteristics-treatments-and-prognostic-factors
#5
Li Fu, Jianlan Xie, Jun Lin, Jingshi Wang, Na Wei, Dayong Huang, Tingting Wang, Jing Shen, Xiaoge Zhou, Zhao Wang
Post-transplant lymphoproliferative disorders (PTLDs) are a heterogeneous group of lymphoid neoplasms associated with immunosuppression following transplantation. Among PTLDs, monomorphic PTLD (m-PTLD) is the largest category; however, its characteristics and survival outcome are not fully understood because of low incidence. This study enrolled 30 adult patients with m-PTLD after kidney-transplantation (KT, n = 17) and hematopoietic stem cell transplantation (HSCT, n = 13) from January 1998 to December 2014...
December 2017: Indian Journal of Hematology & Blood Transfusion
https://www.readbyqxmd.com/read/29057508/impact-of-antiviral-prophylaxis-in-adults-ebv-seronegative-kidney-recipients-on-early-and-late-ptld-onset-a-retrospective-cohort-study
#6
Simon Ville, Berthe-Marie Imbert-Marcille, Marianne Coste-Burel, Claire Garandeau, Aurélie Meurette, Diego Cantarovitch, Magali Giral, Maryvonne Hourmant, Gilles Blancho, Jacques Dantal
Post-transplantation lympho-proliferative disorder (PTLD) pathogenesis is related to EBV infection. Mismatch with the donor (EBV D+/R-) is the main risk factor for both early PTLD (< 1 year post transplantation) and late (> 1 year). In these at-risk patients, the role of antiviral prophylaxis for preventing PTLD remains controversial. We analysed the impact of antiviral drugs given to prevent CMV disease in a mono-centric retrospective cohort of 73 adult kidney or kidney-pancreas EBV seronegative recipients, transplanted between 01/01/2000 and 01/01/2016...
October 23, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/29021960/relapsing-ebv-encephalitis-in-a-renal-transplant-recipient
#7
Joshua A Stone, Bettina M Knoll, Dimitrios Farmakiotis
In solid organ transplant recipients, Epstein-Barr virus (EBV) can cause active central nervous system (CNS) infection or malignant transformation of latently infected cells in the CNS, known as post-transplant lymphoproliferative disease (PTLD). Reduction of T-cell immunosuppression is the cornerstone of management. The role of antivirals with in-vitro activity against herpesviruses in EBV-related CNS syndromes is controversial, as they have no effect on latent virus. We report an unusual case of relapsing EBV encephalitis in a donor-positive, EBV-negative renal transplant recipient, with response to valganciclovir...
2017: IDCases
https://www.readbyqxmd.com/read/29021921/post-transplant-lymphoproliferative-disorder-ptld-single-institutional-experience-of-141-patients
#8
Rohit Bishnoi, Ravneet Bajwa, Aaron J Franke, William Paul Skelton, Yu Wang, Niraj M Patel, William Birdsall Slayton, Fei Zou, Nam H Dang
BACKGROUND: Post-transplant lymphoproliferative disorder is a well-recognized but rare complication of hematopoietic stem cell and solid organ transplant. Due to rarity of this disease, retrospective studies from major transplant centers has been the main source to provide treatment guidelines, which are still in evolution. The sample size of this study is among one of the largest study on PTLD till date reported throughout the world. METHODS: This study was performed at University of Florida which is one of the largest transplant center in South East United States...
2017: Experimental Hematology & Oncology
https://www.readbyqxmd.com/read/28984115/ebv-positive-post-transplant-lymphoproliferative-disorder-presenting-as-primary-diffuse-large-b-cell-lymphoma-of-the-central-nervous-system
#9
Haoliang Xu, Julia Rewerska, Nathan Aardsma, Konstantin Slavin, Tibor Valyi-Nagy, Hongyu Ni
Primary central nervous system post-transplant lymphoproliferative disorder (PCNS-PTLD) is a rare complication with inferior survival outcomes in solid organ transplant patients. It represents approximately 7-15% of all PTLD patients. Because of the rarity of this disease, the diagnosis of PCNS-PTLD is often challenging, and the optimal therapy has not been established. We report a case of a renal transplant patient who initially presented with acute altered neurological function, an enhancing mass lesion of the brain on magnetic resonance imaging (MRI), and nonspecific reactive histopathological changes on brain biopsy...
2017: Folia Neuropathologica
https://www.readbyqxmd.com/read/28915342/transplantation-of-solid-organ-recipients-shedding-epstein-barr-virus-dna-pre-transplant-a-prospective-study
#10
Priya S Verghese, David O Schmeling, Emma A Filtz, Jennifer M Grimm, Arthur J Matas, Henry H Balfour
Epstein-Barr virus (EBV) poses a significant threat to patient and graft survival post-transplant. We hypothesized that recipients who shed EBV at transplant had less immunologic control of the virus and hence were more likely to have active EBV infection and disease post-transplant. To test this hypothesis, we conducted a 5-year prospective study in primary solid organ transplant recipients. We measured EBV DNA in oral washes and blood samples by quantitative PCR before transplant and periodically thereafter for up to 4 years...
September 15, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28874674/lytic-ebv-infection-investigated-by-detection-of-soluble-epstein-barr-virus-zebra-in-the-serum-of-patients-with-ptld
#11
Mohammed Habib, Marlyse Buisson, Julien Lupo, Felix Agbalika, Gérard Socié, Raphaele Germi, Monique Baccard, Berthe-Marie Imbert-Marcille, Jacques Dantal, Patrice Morand, Emmanuel Drouet
The ZEBRA protein (encoded by the BZLF1 gene), is the major transcription factor of EBV, expressed upon EBV lytic cycle activation. Several studies highlighted the critical role of EBV lytic infection as a risk factor for lymphoproliferative disorders like post-transplant lymphoproliferative disease (PTLD). Here, we use an antigen-capture ELISA assay specifically designed to detecting the circulating soluble ZEBRA (sZEBRA) in serum samples (threshold value determined at 40ng/mL). We retrospectively investigated a population of 66 transplanted patients comprising 35 PTLD...
September 5, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28869325/epstein-barr-virus-infection-in-children-with-renal-transplantation-a-single-center-experience
#12
Jihye You, Mijin Kim, Jina Lee, Duck Jong Han, Young Seo Park, Joo Hoon Lee
AIM: This study aimed to investigate the incidence, timing, manifestations, managements, and outcomes of Epstein-Barr virus (EBV) infection in pediatric renal transplant recipients in Korea. METHODS: We retrospectively evaluated 70 patients aged <18 years who had undergone renal transplantation between January 1990 and November 2014 at a single center in Korea. EBV infection was diagnosed via serological test or real-time quantitative polymerase chain reaction (PCR)...
September 4, 2017: Nephrology
https://www.readbyqxmd.com/read/28846558/improved-outcomes-of-kidney-transplantation-in-infants-age-2-years-a-single-center-experience
#13
Blanche M Chavers, Michelle N Rheault, Arthur J Matas, Scott C Jackson, Marie E Cook, Thomas E Nevins, John S Najarian, Srinath Chinnakotla
BACKGROUND: Infants (age < 2 years) with end stage renal disease (ESRD) have increased morbidity and mortality. We evaluated our long-term outcomes of kidney transplants (KTx) in infants. METHODS: Between 1984-2014, 136 infants underwent KTx. We examined trends in survival rates and complications by era (1984-1993 [Era 1], 1994-2003 [Era 2], 2004-2014 [Era 3]). RESULTS: Patients were 92.6% Caucasian and 70.6% male. PostTx initial length of hospital stay declined 37% over the 30-year period (p <0...
August 24, 2017: Transplantation
https://www.readbyqxmd.com/read/28838455/an-unusual-posttransplant-t-cell-lymphoma-after-liver-transplantation-a-case-report
#14
I E Obiorah, M Ozdemirli
Posttransplantation lymphoproliferative disorders (PTLDs) encompass a spectrum of heterogeneous entities ranging from benign lymphocytic proliferations to high-grade malignant lymphomas. The majority of PTLDs are associated with reactivation of Epstein-Barr virus (EBV), which induces B-cell proliferation and occurs in the setting of severe immune suppression after solid organ or bone marrow transplantation. T-cell/natural killer cell PTLDs are relatively rare, constituting ∼15% of all cases. T-cell PTLDs are usually aggressive, and outcomes are poor...
September 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28831836/long-term-outcome-of-epstein-barr-virus-dnaemia-and-ptld-with-the-use-of-preemptive-rituximab-following-allogeneic-hsct
#15
Amelie Kinch, Helene Hallböök, Johan Arvidson, Kalle Sällström, Kåre Bondeson, Karlis Pauksens
We studied retrospectively the outcome of Epstein-Barr virus (EBV)-related disease with EBV monitoring and preemptive rituximab to prevent post-transplant lymphoproliferative disorder (PTLD) in 319 consecutive allogeneic stem cell transplantations 2004-2012. Patients who received anti-thymocyte globulin (ATG) or alemtuzumab were regarded as high-risk for PTLD (n = 214). EBV DNAemia ≥1000 copies/mL plasma was observed in 50 (23%) of the high-risk patients. Thirty-three of the high-risk (15%) and one of the low-risk (1%) patients received rituximab, in combination with reduction of immunosuppression (n = 24) or chemotherapy (n = 4)...
August 23, 2017: Leukemia & Lymphoma
https://www.readbyqxmd.com/read/28766544/-ebv-positive-central-nervous-system-lymphoproliferative-disease-associated-with-immunosuppression-after-organ-transplantation-long-term-remission-without-chemotherapy
#16
O A Gavrilina, V V Troitskaya, E E Zvonkov, E N Parovichnikova, G M Galstyan, L S Biryukova, I V Nesterenko, A M Kovrigina, A V Bazhenov, V G Savchenko, V G Savchenko
Primary central nervous system (CNS) lymphomas account for 13-20% of the posttransplant lymphoproliferative disorders (PTLD) and rank among the most aggressive conditions. Reduction of immunosuppressive therapy should be mandatory to treat PTLD, but this is rarely used as the only therapy option. Chemotherapy regimens for PTLD involving the CNS most commonly include high-dose rituximab and high-dose methotrexate and/or cytarabine. The efficiency only of discontinuation of immunosuppressive therapy for PTLD does not exceed 5-10%, but there are no literature data on its efficiency for PTLD involving the CNS...
2017: Terapevticheskiĭ Arkhiv
https://www.readbyqxmd.com/read/28708333/conversion-from-calcineurin-inhibitors-to-mtor-inhibitors-as-primary-immunosuppressive-drugs-in-pediatric-heart-transplantation
#17
Alfred Asante-Korang, Jennifer Carapellucci, Diane Krasnopero, Abigail Doyle, Brian Brown, Ernest Amankwah
There are only a few reports of successful use of mammalian target of rapamycin (mTORI) as primary immunosuppression in pediatric heart transplantation. Compared to calcineurin inhibitors, mTORI have less side effects, especially nephrotoxicity, infections, and malignancies. A retrospective study was conducted at our institution of all 170 heart transplants from 1995 to 2015. Nineteen patients were switched from tacrolimus (n=15) or cyclosporin (n=4) to everolimus (n=4) or sirolimus (n=15) due to nephrotoxicity (n=5), malignancy (n=8), EBV viremia/reactive plasmacytic changes (n=5), and immune hemolytic anemia (n=1)...
July 14, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28706985/clinical-utility-of-epstein-barr-virus-viral-load-monitoring-and-risk-factors-for-posttransplant-lymphoproliferative-disorders-after-kidney-transplantation-a-single-center-10-year-observational-cohort-study
#18
Erica Franceschini, Jessica Plessi, Stefano Zona, Antonella Santoro, Margherita Digaetano, Francesco Fontana, Gaetano Alfano, Giovanni Guaraldi, Patrizia Comoli, Francesca Facchini, Leonardo Potenza, William Gennari, Mauro Codeluppi, Mario Luppi, Gianni Cappelli, Inge C Gyssens, Cristina Mussini
BACKGROUND: Posttransplant lymphoproliferative disease (PTLD) is an important cause of morbidity and mortality in solid organ transplants. Epstein Barr virus (EBV) plays a major role in PTLD development. Guidelines recommend EBV viral load (VL) monitoring in high-risk populations in the first year. METHODS: Retrospective observational study in all adult patients who had at least 1 EBV-VL performed in the postkidney transplant (KT) period from January 2005 to December 2014 at the Policlinico Modena Hospital...
July 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28699897/posttransplant-lymphoproliferative-disorders-in-kidney-transplant-recipients-a-retrospective-cohort-analysis-over-two-decades-in-hong-kong
#19
Chi Yuen Cheung, Maggie Kam Man Ma, Ka Foon Chau, Wai Leung Chak, Sydney Chi Wai Tang
OBJECTIVE: To characterize the posttransplant lymphoproliferative disorders (PTLD) including the Epstein-Barr virus (EBV) status, histological subgroups, site of occurrence and the clinical outcome in the Chinese kidney transplant recipients. METHODS: A retrospective cohort study of 1, 227 adult kidney transplant recipients who were followed up in two transplant centers in Hong Kong over two decades. RESULTS: 23 (1.9%) patients developed PTLD...
June 30, 2017: Oncotarget
https://www.readbyqxmd.com/read/28667038/post-transplant-lymphoproliferative-disorder-presented-in-a-form-of-primary-effusion-lymphoma-with-t-8-14
#20
Sadia Sultana, Suhair Al Salihi, Nidhi Tandon, Jesse Jaso, Nghia D Nguyen, Songlin Zhang, Jing Liu
Post-transplant lymphoproliferative disorders (PTLD) are emergent complications of organ transplantation occurring in 2% to 10% of transplanted patients. Epstein-Barr virus (EBV) infections are considered the most important factors for the development of these heterogeneous disorders. Primary effusion lymphoma (PEL) is a lymphoproliferative disorder predominantly described in patients with advanced AIDS and it is almost universally associated with human herpesvirus 8 (HHV8). In rare case, PEL also occurs in HHV8-negative patient, in the setting of hepatitis B and C virus infection...
May 2017: Annals of Clinical and Laboratory Science
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