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https://www.readbyqxmd.com/read/28708333/conversion-from-calcineurin-inhibitors-to-mtor-inhibitors-as-primary-immunosuppressive-drugs-in-pediatric-heart-transplantation
#1
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 1995-2015. 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
#2
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
#3
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
#4
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
https://www.readbyqxmd.com/read/28653462/no-effect-of-treatment-with-intravenous-ganciclovir-on-epstein-barr-virus-viremia-demonstrated-after-pediatric-liver-transplantation
#5
Anniken B Østensen, Truls Sanengen, Ellen Holter, Pål-Dag Line, Runar Almaas
EBV after pediatric LT is a risk factor for PTLD. We wanted to evaluate the effect of intravenous ganciclovir on EBV viremia and to identify risk factors for chronic EBV viremia. All pediatric patients who underwent LT in Norway from 2002 until 2015 were reviewed. Twenty-two of 38 patients with viremia were treated with intravenous ganciclovir for a median of 22 (21-38) days. Treated and untreated patients were not different with respect to EBV seroconversion prior to transplantation or age at transplantation, but treated patients had significantly earlier viremia after transplantation (P=...
June 26, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28639398/epstein-barr-viral-loads-do-not-predict-post-transplant-lymphoproliferative-disorder-in-pediatric-lung-transplant-recipients-a-multicenter-prospective-cohort-study
#6
Andrew Parrish, Matthew Fenchel, Gregory A Storch, Richard Buller, Sheila Mason, Nikki Williams, David Ikle, Carol Conrad, Albert Faro, Samuel Goldfarb, Don Hayes, Ernestina Melicoff-Portillo, Marc Schecter, Gary Visner, Stuart Sweet, Lara Danziger-Isakov
Prediction of PTLD after pediatric lung transplant remains difficult. Use of EBV VL in WB has been poorly predictive, while measurement of VL in BAL fluid has been suggested to have enhanced utility. The NIH-sponsored Clinical Trials in Organ Transplantation in Children (CTOTC-03) prospectively obtained serial quantitative measurements of EBV PCR in both WB and BAL fluid after pediatric lung transplantation. Descriptive statistics, contingency analyses, and Kaplan-Meier analyses evaluated possible association between EBV and PTLD...
June 21, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28581032/preemptive-therapy-with-rituximab-for-epstein-barr-virus-reactivation-after-haplo-hsct
#7
Shogo Kobayashi, Hideki Sano, Kazuhiro Mochizuki, Yoshihiro Ohara, Nobuhisa Takahashi, Hitoshi Ohto, Atsushi Kikuta
BACKGROUND: Epstein-Barr virus-related post-transplantation lymphoproliferative disorder (EBV-PTLD) is a serious complication in hematopoietic stem cell transplantation (HSCT) recipients. METHODS: We conducted a retrospective study to investigate the incidence and potential risk factors for EBV reactivation and to assess the efficacy of the management of EBV reactivation with preemptive rituximab in children who had T-cell-replete haploidentical HSCT (TCR-haplo-SCT) with low-dose anti-thymocyte globulin (ATG)...
June 5, 2017: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/28556519/lessons-learned-early-termination-of-a-randomized-trial-of-calcineurin-inhibitor-and-corticosteroid-avoidance-using-belatacept
#8
Kenneth A Newell, Aneesh K Mehta, Christian P Larsen, Peter G Stock, A Bradley Farris, Shikha G Mehta, David Ikle, Brian Armstrong, Yvonne Morrison, Nancy Bridges, Mark Robien, Roslyn B Mannon
The intent of this NIH-sponsored study was to compare a belatacept-based immunosuppressive regimen with a maintenance regimen of tacrolimus and mycophenolate (MMF). Nineteen primary, EBV-immune renal transplant recipients with a negative cross-match were randomized to one of three groups. All patient groups received perioperative steroids and maintenance MMF. Patients in groups 1 and 2 were induced with alemtuzumab and maintained on tacrolimus or belatacept, respectively. Patients in group 3 were induced with basiliximab, received 3 months of tacrolimus, and maintained on belatacept...
May 28, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28535360/posttransplant-lymphoproliferative-disorder-otolaryngological-manifestations-and-management
#9
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
#10
Jillian SY Lau, Zhi Mei Low, Iain Abbott, Lani Shochet, John Kanellis, Arthur Richard 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/28499936/umbilical-cord-blood-transplantation-without-antithymocyte-globulin-results-in-similar-survival-but-better-quality-of-life-compared-with-unrelated-peripheral-blood-stem-cell-transplantation-for-the-treatment-of-acute-leukemia-a-retrospective-study-in-china
#11
Juan Tong, Li Xuan, Yanling Sun, Dongping Huang, Huilan Liu, Changcheng Zheng, Xiaoyu Zhu, Baolin Tang, Kaidi Song, Xuhan Zhang, Lei Zhang, Wen Yao, Dongjun Lin, Qifa Liu, Zimin Sun
Although 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), we conducted 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/28489256/clinical-and-virologic-outcomes-in-high-risk-adult-epstein-barr-virus-mismatched-organ-transplant-recipients
#12
Deepali Kumar, Nikhil Patil, Shahid Husain, Cecilia Chaparro, Mamatha Bhat, S Joseph Kim, Atul Humar
Epstein-Barr virus (EBV) D+/R- organ transplant recipients are a high-risk group for developing post-transplant lymphoproliferative disease (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...
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
#13
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/28456611/increased-risk-of-ptld-in-lung-transplant-recipients-with-cystic-fibrosis
#14
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/28419429/mutational-landscape-of-b-cell-post-transplant-lymphoproliferative-disorders
#15
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
#16
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/posttransplant-lymphoproliferative-disorder-after-clinical-islet-transplantation-report-of-the-first-two-cases
#17
A Peters, T Olateju, J Deschenes, S H Shankarnarayan, N Chua, A M J Shapiro, P Senior
We report the first two cases of posttransplant lymphoproliferative disorder (PTLD) in recipients of islet transplants worldwide. First, a 44-year-old recipient of three islet infusions developed PTLD 80 months after his initial transplantation, 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 underwent consolidative autologous stem cell transplantation...
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
#18
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/28376031/the-immune-response-to-epstein-barr-virus-and-implications-for-posttransplant-lymphoproliferative-disorder
#19
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/28355720/-the-clinical-characteristics-of-adult-hemophagocytic-lymphohistiocytosis-treated-with-haploidentical-donor-hematopoietic-stem-cell-transplantation
#20
L Fu, N Wei, J S Wang, L Wu, Y N Wang, D Y Huang, J L Liu, Z Wang
Objective: To analyze the clinical characteristics of adult patients with hemophagocytic lymphohistiocytosis (HLH) receiving haploidentical donor hematopoietic stem cell transplantation (HID HSCT). Method: We retrospectively reviewed 20 adult patients with HLH from August 2009 to August 2014.The clinical features and outcome were analyzed. Results: Conditioning regimens consisted of total body irradiation/etoposide/cyclophosphamide (TBI/VP-16/CTX) and busulfan (Bu)/VP-16/CTX in HLH with anti-thymocyte globulin (ATG) 8 mg/kg...
April 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
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