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Ebv ptld

Jade Le
Epstein-Barr virus (EBV) and human herpesvirus-8 (HHV-8) are γ herpesviruses associated with post-transplant malignancies in kidney transplant recipients. EBV is associated with post-transplantation lymphoproliferative disorder (PTLD), with increased risk in EBV-seronegative patients on intensified immunosuppression. Human herpesvirus-8 is associated with Kaposi's sarcoma (KS), with an increased risk in certain patient populations. Diagnosis of PTLD and KS relies on tissue biopsy. The mainstay of therapy for both PTLD and Kaposi's sarcoma is a reduction of immunosuppression, and in the case of PTLD, consideration of rituximab...
September 2016: Seminars in Nephrology
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
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
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
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
Thomas Schachtner, Petra 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
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
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
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
Marieke L Nijland, Marie José Kersten, Steven T Pals, Frederike J Bemelman, Ineke J M Ten Berge
Posttransplant lymphoproliferative disease (PTLD) is a potentially fatal complication after (solid organ) transplantation, which is highly associated with Epstein-Barr virus (EBV). The EBV-specific cytotoxic T cell response that is essential in controlling the virus in healthy individuals is suppressed in transplant recipients using immunosuppressive drugs. A primary EBV infection in EBV-seronegative patients receiving an EBV-seropositive donor organ or a reactivation in those who are already latently infected pretransplantation can lead to uninhibited growth of EBV-infected B cells and subsequently to PTLD...
January 2016: Transplantation Direct
Lisa Rausch, Christian Koenecke, Hans-Friedrich Koch, Alexander Kaltenborn, Nikos Emmanouilidis, Lars Pape, Frank Lehner, Viktor Arelin, Ulrich Baumann, Harald Schrem
BACKGROUND: Post-transplant lymphoproliferative disorder (PTLD) adversely affects patients' long-term outcome. METHODS: The paired t test and McNemar's test were applied in a retrospective 1:1 matched-pair analysis including 36 patients with PTLD and 36 patients without PTLD after kidney or liver transplantation. Matching criteria were age, gender, indication, type of transplantation, and duration of follow-up. All investigated PTLD specimen were histologically positive for EBV...
2016: Transplantation Research
Q Zhang, B H Zou, X Lou, H Liu, B Zhang, H Chen
OBJECTIVE: To analyze the incidence of Epstein-Barr virus (EBV) infection in patients after allogeneic hematopoietic stem cell transplantation (HSCT), and investigate its risk factors and prognosis. METHODS: A total of 402 patients receiving HSCT were retrospectively studied from November 2011 to November 2014 in the 307th Hospital of Chinese People's Liberation Army.The cumulative incidence (CI) of EBV infection and survival rate were analyzed by Kaplan-Meier method, while risk factors were assessed by logistic regression model...
August 1, 2016: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
Xinmiao Jiang, Lanping Xu, Yu Zhang, Fen Huang, Daihong Liu, Jin Sun, Chaoyang Song, Xinquan Liang, Zhiping Fan, Hongsheng Zhou, Min Dai, Can Liu, Qianli Jiang, Na Xu, Li Xuan, Meiqing Wu, Xiaojun Huang, Qifa Liu
To improve prognosis of post-transplant lymphoproliferative disease (PTLD), a sequential therapeutic strategy that rituximab-based treatments followed by donor lymphocyte infusion (DLI) or autologous EBV-specific cytotoxic T lymphocytes (EBV-CTL) for biopsy-proven EBV-associated PTLD in recipients of allogeneic hematopoietic stem cell transplantation was designed. 84 patients with EBV-PTLD were enrolled in this prospective study. After two cycles of the rituximab-based treatments, 68 of 84 patients (81% [95% CI 71-88]) responded and 52 (62% [51-72]) had CRs...
May 2016: Oncoimmunology
Li Fu, Jingshi Wang, Na Wei, Lin Wu, Yini Wang, Wenqiu Huang, Jia Zhang, Jinli Liu, Zhao Wang
Myeloablative conditioning-based allogeneic hematopoietic stem-cell transplantation (allo-HSCT) in the treatment of adult and adolescent hemophagocytic lymphohistiocytosis (HLH) is rarely reported. We conducted a retrospective study of 30 adult and adolescent HLH transplanted for primary HLH (n = 4), tumor-HLH (n = 8), EBV-HLH (n = 14), and underlying disease-unknown (UDU)-HLH (n = 4). Peripheral blood stem cells (PBSCs) were the stem-cell source in all patients. Twenty-three patients were transplanted from HLA-haploidentical family donors, six from HLA-identical sibling donors, and one from a matched unrelated donor...
July 18, 2016: International Journal of Hematology
Marcus A Carden, Shelley Caltharp, Marianne E Yee, Ann E Haight, Lars F Westblade, Sunita Park
Monomorphic plasmacytoma-type posttransplant lymphoproliferative disorder (PTLD) has not been reported after pediatric hematopoietic stem cell transplantation. We present a child with hepatitis-associated severe aplastic anemia who underwent an unrelated allogeneic hematopoietic stem cell transplantation and subsequently developed graft failure and an Epstein-Barr virus-positive monomorphic plasmacytoma-type PTLD of recipient origin. Despite broad-spectrum antimicrobials, weaning immunosuppression, rituximab administration, and a stem cell boost she died from complications of PTLD and a fungal pulmonary infection on day +78...
November 2016: Journal of Pediatric Hematology/oncology
Ya-Chi Huang, Sue-Jane Lin, Kai-Min Lin, Ya-Ching Chou, Chung-Wu Lin, Shan-Chi Yu, Chi-Long Chen, Tang-Long Shen, Chi-Kuan Chen, Jean Lu, Mei-Ru Chen, Ching-Hwa Tsai
Epstein-Barr virus (EBV), an oncogenic human virus, is associated with several lymphoproliferative disorders, including Burkitt lymphoma, Hodgkin disease, diffuse large B-cell lymphoma (DLBCL), and posttransplant lymphoproliferative disorder (PTLD). In vitro, EBV transforms primary B cells into lymphoblastoid cell lines (LCLs). Recently, several studies have shown that receptor tyrosine kinases (RTKs) play important roles in EBV-associated neoplasia. However, details of the involvement of RTKs in EBV-regulated B-cell neoplasia and malignancies remain largely unclear...
September 22, 2016: Blood
Allison F O'Neill, Eelam A Adil, Alexandria L Irace, Laura Neff, Ian J Davis, Antonio R Perez-Atayde, Stephan D Voss, Olga Weinberg, Reza Rahbar
OBJECTIVE: Post-transplant lymphoproliferative disorder (PTLD) is a rare complication of immunosuppression with little consensus on its evaluation and management. The purpose of this contemporary review is to describe a pediatric patient with PTLD of the airway and review the literature to provide multidisciplinary recommendations regarding management. DATA SOURCES: Retrospective chart and literature review. REVIEW METHODS: A pediatric patient with PTLD of the airway is described...
July 2016: International Journal of Pediatric Otorhinolaryngology
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