Display options
Cite
Nijland ML, Kersten MJ, Pals ST, et al. Epstein-Barr Virus-Positive Posttransplant Lymphoproliferative Disease After Solid Organ Transplantation: Pathogenesis, Clinical Manifestations, Diagnosis, and Management. Transplant Direct. 2015;2(1):e48doi: 10.1097/TXD.0000000000000557.
Nijland, M. L., Kersten, M. J., Pals, S. T., Bemelman, F. J., & Ten Berge, I. J. (2016). Epstein-Barr Virus-Positive Posttransplant Lymphoproliferative Disease After Solid Organ Transplantation: Pathogenesis, Clinical Manifestations, Diagnosis, and Management. Transplantation direct, 2(1), e48. https://doi.org/10.1097/TXD.0000000000000557
Nijland, Marieke L, et al. "Epstein-Barr Virus-Positive Posttransplant Lymphoproliferative Disease After Solid Organ Transplantation: Pathogenesis, Clinical Manifestations, Diagnosis, and Management." Transplantation direct vol. 2,1 (2016): e48. doi: https://doi.org/10.1097/TXD.0000000000000557
Nijland ML, Kersten MJ, Pals ST, Bemelman FJ, Ten Berge IJ. Epstein-Barr Virus-Positive Posttransplant Lymphoproliferative Disease After Solid Organ Transplantation: Pathogenesis, Clinical Manifestations, Diagnosis, and Management. Transplant Direct. 2015 Dec 15;2(1):e48. doi: 10.1097/TXD.0000000000000557. eCollection 2016 Jan. PMID: 27500242; PMCID: PMC4946499.
Copy Download .nbib Format: NLM
Share it on

Transplant Direct. 2015 Dec 15;2(1):e48. doi: 10.1097/TXD.0000000000000557. eCollection 2016 Jan.

Epstein-Barr Virus-Positive Posttransplant Lymphoproliferative Disease After Solid Organ Transplantation: Pathogenesis, Clinical Manifestations, Diagnosis, and Management.

Transplantation direct

Marieke L Nijland, Marie José Kersten, Steven T Pals, Frederike J Bemelman, Ineke J M Ten Berge

Affiliations

  1. Renal Transplant Unit, Department of Nephrology, Academic Medical Center, Amsterdam, The Netherlands.
  2. Department of Hematology and Lymphoma and Myeloma Center Amsterdam (LYMMCARE), Academic Medical Center, Amsterdam, The Netherlands.
  3. Department of Pathology and Lymphoma and Myeloma Center Amsterdam (LYMMCARE), Academic Medical Center, Amsterdam, The Netherlands.

PMID: 27500242 PMCID: PMC4946499 DOI: 10.1097/TXD.0000000000000557

Abstract

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. Effective preventive strategies, such as vaccines and antiviral agents, are lacking. Because not every transplant recipient with increasing EBV viral load develops PTLD, it is hard to decide how intensively these patients should be monitored and how and when a preemptive intervention should take place. There is a need for other tools to help predict the development of PTLD in patients at risk to make timing and strategy of preemptive intervention easier and more reliable. The cornerstone of the treatment of patients with PTLD is restoring the host's immunity by reduction of immunosuppressive drug therapy. American and British guidelines recommend to add rituximab monotherapy or rituximab in combination with cyclophosphamide, doxorubicin, vincristine, and prednisolone, depending on histology and clinical characteristics. Although response to these therapies is good, toxicity is a problem, and PTLD still has a relatively high mortality rate. An evolving therapy, especially in PTLD occurring in allogeneic stem cell transplantation, is restoring the host's immune response with infusion of EBV-specific cytotoxic T cells. This may also play a role in the future in both prevention and treatment of PTLD in SOT.

References

  1. N Engl J Med. 2004 Mar 25;350(13):1328-37 - PubMed
  2. Int J Cancer. 2013 Nov 15;133(10):2341-50 - PubMed
  3. Am J Transplant. 2011 May;11(5):888-95 - PubMed
  4. N Engl J Med. 2014 Oct 16;371(16):1507-17 - PubMed
  5. Annu Rev Immunol. 2007;25:587-617 - PubMed
  6. Ann Hematol. 2007 Aug;86(8):599-607 - PubMed
  7. Am J Transplant. 2004 Feb;4(2):222-30 - PubMed
  8. Am J Transplant. 2013 Aug;13(8):2035-43 - PubMed
  9. Nephrol Dial Transplant. 2012 Jul;27(7):2971-9 - PubMed
  10. Am J Kidney Dis. 2010 Jan;55(1):168-80 - PubMed
  11. Br J Haematol. 2010 Jun;149(5):693-705 - PubMed
  12. Leuk Lymphoma. 2002 Apr;43(4):831-40 - PubMed
  13. Blood. 2002 Apr 1;99(7):2592-8 - PubMed
  14. Lancet Oncol. 2012 Feb;13(2):196-206 - PubMed
  15. N Engl J Med. 2015 Feb 5;372(6):569-71 - PubMed
  16. Clin Microbiol Rev. 2011 Jan;24(1):193-209 - PubMed
  17. Lancet Infect Dis. 2007 Jul;7(7):460-72 - PubMed
  18. Pharmacol Res. 2011 Jan;63(1):1-7 - PubMed
  19. Am J Transplant. 2013 Mar;13 Suppl 4:107-20 - PubMed
  20. Nat Rev Immunol. 2003 Oct;3(10):801-12 - PubMed
  21. J Clin Oncol. 2001 Feb 1;19(3):772-8 - PubMed
  22. Rev Med Virol. 2005 Jan-Feb;15(1):3-15 - PubMed
  23. Clin Dev Immunol. 2013;2013:150835 - PubMed
  24. Transplantation. 2010 Jul 15;90(1):93-4 - PubMed
  25. Cancer Cell. 2014 Oct 13;26(4):565-76 - PubMed
  26. Blood. 2014 Oct 16;124(16):2514-22 - PubMed
  27. Clin Microbiol Rev. 2010 Apr;23(2):350-66 - PubMed
  28. Transplantation. 2001 Apr 27;71(8):1076-88 - PubMed
  29. Am J Transplant. 2012 Nov;12(11):3069-75 - PubMed
  30. J Clin Microbiol. 2008 Jan;46(1):157-63 - PubMed
  31. N Engl J Med. 2012 Jul 26;367(4):329-39 - PubMed
  32. Transplantation. 2002 May 27;73(10):1603-10 - PubMed
  33. Lancet Oncol. 2007 Mar;8(3):212-8 - PubMed
  34. Transplantation. 2005 Oct 15;80(7):883-9 - PubMed
  35. Am J Transplant. 2005 Dec;5(12):2894-900 - PubMed
  36. Am J Transplant. 2012 Mar;12(3):682-93 - PubMed
  37. Transplantation. 2008 Mar 15;85(5):707-12 - PubMed
  38. Pharmacol Ther. 2015 Feb;146:53-60 - PubMed
  39. Transplantation. 2000 Mar 15;69(5):827-33 - PubMed
  40. Am J Transplant. 2007 Feb;7(2):271-7 - PubMed
  41. Br J Haematol. 2010 Jun;149(5):675-92 - PubMed
  42. Blood. 2004 May 15;103(10):3979-81 - PubMed
  43. Vaccine. 2013 Apr 18;31 Suppl 2:B194-6 - PubMed
  44. J Heart Lung Transplant. 2008 Jan;27(1):100-5 - PubMed
  45. N Engl J Med. 2000 Aug 17;343(7):481-92 - PubMed
  46. Blood. 2006 Nov 1;108(9):2942-9 - PubMed
  47. Am J Transplant. 2005 Sep;5(9):2222-8 - PubMed
  48. Blood. 2007 Aug 15;110(4):1123-31 - PubMed
  49. Am J Surg Pathol. 2000 Mar;24(3):375-85 - PubMed
  50. J Clin Microbiol. 2007 Jul;45(7):2151-5 - PubMed
  51. Transpl Immunol. 2005 Jun;14(2):109-16 - PubMed
  52. Trends Immunol. 2008 Apr;29(4):195-201 - PubMed
  53. Am J Transplant. 2014 Apr;14(4):857-66 - PubMed
  54. Am J Kidney Dis. 2006 May;47(5):e67-72 - PubMed
  55. Transplantation. 2005 Nov 15;80(9):1233-43 - PubMed
  56. Transpl Infect Dis. 2001 Jun;3(2):70-8 - PubMed
  57. Clin Microbiol Infect. 2014 Sep;20 Suppl 7:109-18 - PubMed
  58. Am J Transplant. 2013 Feb;13 Suppl 3:41-54; quiz 54 - PubMed
  59. Am J Transplant. 2006 May;6(5 Pt 1):1017-24 - PubMed
  60. Blood. 2011 Feb 10;117(6):1977-85 - PubMed
  61. N Engl J Med. 2005 Mar 31;352(13):1317-23 - PubMed
  62. Am J Transplant. 2011 Feb;11(2):336-47 - PubMed
  63. Virology. 2015 May;479-480:568-77 - PubMed
  64. Adv Virol. 2012;2012:509296 - PubMed
  65. Mol Ther. 2013 Nov;21(11):2113-21 - PubMed
  66. Transplantation. 2009 Oct 27;88(8):1025-9 - PubMed
  67. Transpl Int. 2014 Sep;27(9):956-65 - PubMed
  68. Blood. 2001 Mar 1;97(5):1165-71 - PubMed
  69. Am J Transplant. 2013 Dec;13(12):3244-52 - PubMed
  70. Am J Transplant. 2006 Jul;6(7):1731-6 - PubMed
  71. Br J Haematol. 2014 Oct;167(1):19-32 - PubMed
  72. J Clin Oncol. 2005 Oct 20;23(30):7574-82 - PubMed
  73. Am J Transplant. 2007 Nov;7(11):2619-25 - PubMed
  74. Mol Ther. 2012 Aug;20(8):1622-32 - PubMed
  75. Proc Natl Acad Sci U S A. 2000 Apr 11;97(8):4285-90 - PubMed
  76. Am J Transplant. 2008 May;8(5):1016-24 - PubMed
  77. Kidney Int. 2014 Jan;85(1):182-90 - PubMed
  78. J Infect Dis. 2007 Dec 15;196(12):1749-53 - PubMed
  79. Am J Transplant. 2009 Feb;9(2):269-79 - PubMed
  80. Transplantation. 2003 May 27;75(10):1710-7 - PubMed

Publication Types