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1. Oertel SH, Verschuuren E, Reinke P, Zeidler K, Papp-Váry M, Babel N, Trappe RU, Jonas S, Hummel M, Anagnostopoulos I, Dörken B, Riess HB: Effect of anti-CD 20 antibody rituximab in patients with post-transplant lymphoproliferative disorder (PTLD). Am J Transplant; 2005 Dec;5(12):2901-6
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Effect of anti-CD 20 antibody rituximab in patients with post-transplant lymphoproliferative disorder (PTLD).
  • Post-transplant lymphoproliferative disorders (PTLD) are a life-threatening complication following solid organ transplantation.
  • Treatment with rituximab, a humanized anti-CD20 monoclonal antibody, has proved to be a promising approach and shown a low toxicity profile.
  • Between February 1999 and April 2002, we conducted a multicentre phase II trial investigating rituximab as single agent in 17 patients with PTLD.
  • The mean follow-up time is 24.2 months.
  • Histology was distributed in 10 diffuse large cell-, 2 marginal zone-, 1 Burkitt-like lymphoma, 1 Hodgkin-like PTLD and 3 polymorphic lymphoproliferations.
  • Therapy was well tolerated and no severe adverse events were observed.
  • Rituximab proved to be well tolerated and effective in the treatment of PTLD.
  • [MeSH-major] Antibodies, Monoclonal / administration & dosage. Antigens, CD20 / immunology. Antineoplastic Agents / administration & dosage. Lymphoproliferative Disorders / drug therapy. Transplants
  • [MeSH-minor] Adult. Aged. Antibodies, Monoclonal, Murine-Derived. Female. Heart Transplantation. Humans. Kidney Transplantation. Liver Transplantation. Lung Transplantation. Male. Middle Aged. Postoperative Complications / drug therapy. Postoperative Complications / immunology. Postoperative Complications / mortality. Prognosis. Prospective Studies. Rituximab. Treatment Outcome

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  • (PMID = 16303003.001).
  • [ISSN] 1600-6135
  • [Journal-full-title] American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons
  • [ISO-abbreviation] Am. J. Transplant.
  • [Language] eng
  • [Publication-type] Clinical Trial, Phase II; Journal Article; Multicenter Study
  • [Publication-country] Denmark
  • [Chemical-registry-number] 0 / Antibodies, Monoclonal; 0 / Antibodies, Monoclonal, Murine-Derived; 0 / Antigens, CD20; 0 / Antineoplastic Agents; 4F4X42SYQ6 / Rituximab
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2. Okuno K, Horie Y, Kanai K, Kato M, Kuwamoto S, Okazaki T, Hayashi K: Epstein-Barr virus associated post-transplant Hodgkin lymphoma in an adult patient after cord blood stem cell transplantation for acute lymphoblastic leukemia. J Clin Exp Hematop; 2009 May;49(1):45-51
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  • [Title] Epstein-Barr virus associated post-transplant Hodgkin lymphoma in an adult patient after cord blood stem cell transplantation for acute lymphoblastic leukemia.
  • Post-transplant lymphoproliferative disorder (PTLD) is one of the most important complications of solid organ transplantation or hematopoietic stem cell transplantation.
  • Although post-transplant Hodgkin lymphoma (HL) is included in PTLD, there have been no studies in the literature on adult cases of post-transplant HL after cord blood stem cell transplantation (CBSCT).
  • This is due to the fact that EBV infection of cord blood cells usually does not occur, and EBV-infected lymphocytes of the recipient should be eradicated by preconditioning therapy.
  • We report a 26-year-old woman case of post-transplant HL, which occurred after CBSCT for relapsed acute lymphoblastic leukemia.
  • Three years and eight months after CBSCT, the enlarged cervical lymph node was histologically diagnosed as EBV associated post-transplant HL, which showed immunophenotypes of classical HL and latency type II EBV infection.
  • She underwent chemotherapy, and has survived 4 years and 6 months after CBSCT.
  • Differential diagnosis of post-transplant HL with good prognosis and HL-like PTLD with aggressive behavior is important, and immunohistochemical methods were useful and essential for it.
  • [MeSH-major] Cord Blood Stem Cell Transplantation / adverse effects. Hodgkin Disease / etiology. Precursor Cell Lymphoblastic Leukemia-Lymphoma / etiology
  • [MeSH-minor] Diagnosis, Differential. Epstein-Barr Virus Infections / etiology. Female. Herpesvirus 4, Human. Humans. Neoplasms, Second Primary / drug therapy. Neoplasms, Second Primary / etiology. Treatment Outcome. Young Adult


3. Markasz L, Stuber G, Flaberg E, Jernberg AG, Eksborg S, Olah E, Skribek H, Szekely L: Cytotoxic drug sensitivity of Epstein-Barr virus transformed lymphoblastoid B-cells. BMC Cancer; 2006;6:265
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  • [Title] Cytotoxic drug sensitivity of Epstein-Barr virus transformed lymphoblastoid B-cells.
  • BACKGROUND: Epstein-Barr virus (EBV) is the causative agent of immunosuppression associated lymphoproliferations such as post-transplant lymphoproliferative disorder (PTLD), AIDS related immunoblastic lymphomas (ARL) and immunoblastic lymphomas in X-linked lymphoproliferative syndrome (XLP).
  • The reported overall mortality for PTLD often exceeds 50%.
  • Reducing the immunosuppression in recipients of solid organ transplants (SOT) or using highly active antiretroviral therapy in AIDS patients leads to complete remission in 23-50% of the PTLD/ARL cases but will not suffice for recipients of bone marrow grafts.
  • An additional therapeutic alternative is the treatment with anti-CD20 antibodies (Rituximab) or EBV-specific cytotoxic T-cells.
  • Chemotherapy is used for the non-responding cases only as the second or third line of treatment.
  • The most frequently used chemotherapy regimens originate from the non-Hodgkin lymphoma protocols and there are no cytotoxic drugs that have been specifically selected against EBV induced lymphoproliferative disorders.
  • METHODS: As lymphoblastoid cell lines (LCLs) are well established in vitro models for PTLD, we have assessed 17 LCLs for cytotoxic drug sensitivity.
  • RESULTS: Independently of their origin, LCLs showed very similar drug sensitivity patterns against 29 frequently used cytostatic drugs.
  • CONCLUSION: Our data shows that the inclusion of epirubicin and paclitaxel into chemotherapy protocols against PTLD may be justified.
  • [MeSH-major] Antineoplastic Agents / toxicity. Antiviral Agents / pharmacology. B-Lymphocytes / virology. Cell Transformation, Viral. Herpesvirus 4, Human / physiology. Lymphoma / drug therapy. Lymphoproliferative Disorders / drug therapy

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  • (PMID = 17101045.001).
  • [ISSN] 1471-2407
  • [Journal-full-title] BMC cancer
  • [ISO-abbreviation] BMC Cancer
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Antiviral Agents
  • [Other-IDs] NLM/ PMC1664586
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4. Zambelli A, Lilleri D, Baldanti F, Scelsi M, Villani L, Da Prada GA: Hodgkin's disease as unusual presentation of post-transplant lymphoproliferative disorder after autologous hematopoietic cell transplantation for malignant glioma. BMC Cancer; 2005;5:109
MedlinePlus Health Information. consumer health - Hodgkin Disease.

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  • [Title] Hodgkin's disease as unusual presentation of post-transplant lymphoproliferative disorder after autologous hematopoietic cell transplantation for malignant glioma.
  • BACKGROUND: Post-transplant lymphoproliferative disorder (PTLD) is a complication of solid organ and allogeneic hematopoietic stem cell transplantation (HSCT); following autologous HSCT only rare cases of PTLD have been reported.
  • Here, a case of Hodgkin's disease (HD), as unusual presentation of PTLD after autologous HSCT for malignant glioma is described.
  • CASE PRESENTATION: 60-years old man affected by cerebral anaplastic astrocytoma underwent subtotal neurosurgical excision and subsequent high-dose chemotherapy followed by autologous HSCT.
  • During the post HSCT course, cranial irradiation and corticosteroids were administered as completion of therapeutic program.
  • At day +105 after HSCT, the patient developed HD, nodular sclerosis type, with polymorphic HD-like skin infiltration.
  • CONCLUSION: The clinical and pathological findings were consistent with the diagnosis of PTLD.
  • [MeSH-major] Glioma / therapy. Hematopoietic Stem Cell Transplantation / adverse effects. Hodgkin Disease / diagnosis. Lymphoproliferative Disorders / etiology. Transplantation, Homologous / adverse effects
  • [MeSH-minor] Adrenal Cortex Hormones / therapeutic use. Antineoplastic Agents / therapeutic use. Humans. Lymphatic Metastasis. Male. Middle Aged

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  • (PMID = 16117828.001).
  • [ISSN] 1471-2407
  • [Journal-full-title] BMC cancer
  • [ISO-abbreviation] BMC Cancer
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Adrenal Cortex Hormones; 0 / Antineoplastic Agents
  • [Other-IDs] NLM/ PMC1208867
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5. Vaglio A, Manenti L, Mancini C, Chierici E, Cobelli R, Bacci F, Palmisano A, Buzio C, Bignardi L, Maggiore U: EBV-associated leukoencephalopathy with late onset of central nervous system lymphoma in a kidney transplant recipient. Am J Transplant; 2010 Apr;10(4):947-51
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  • [Title] EBV-associated leukoencephalopathy with late onset of central nervous system lymphoma in a kidney transplant recipient.
  • Central nervous system (CNS) lymphoma is a rare posttransplant lymphoproliferative disorder (PTLD), which usually has a poor outcome.
  • We here describe the case of a renal transplant patient who was initially diagnosed as having Epstein-Barr virus (EBV)-associated leukoencephalopathy and ultimately developed EBV-positive CNS lymphoma.
  • After acyclovir therapy and immunosuppressive drug tapering, the symptoms and electroencephalographic abnormalities subsided, and EBV-DNA disappeared from the CSF.
  • After excision, a diagnosis of EBV-positive, Hodgkin-like monomorphic B-cell PTLD was made.
  • This case illustrates the potential pathophysiological relationships between EBV infection, leukoencephalopathy and CNS lymphoma; although a long time elapsed from the initial neurological illness to CNS lymphoma, a link between these two conditions cannot be excluded.
  • [MeSH-major] Brain Neoplasms / diagnosis. Herpesvirus 4, Human / pathogenicity. Kidney Transplantation. Leukoencephalopathies / diagnosis. Lymphoma / diagnosis. Tumor Virus Infections / diagnosis
  • [MeSH-minor] Adult. Antiviral Agents / therapeutic use. Female. Humans. Kidney Failure, Chronic / surgery. Magnetic Resonance Imaging. Positron-Emission Tomography

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  • (PMID = 20420644.001).
  • [ISSN] 1600-6143
  • [Journal-full-title] American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons
  • [ISO-abbreviation] Am. J. Transplant.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antiviral Agents
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6. Geramizadeh B, Malek-Hosseini SA, Bahador A, Salahi H, Nikeghbalian S, Sharifian M, Lankarani KB, Imanieh MH, Dehghani M: Post-transplantation lymphoproliferative disorder after liver transplantation: report of 5 cases among more than 550 liver transplants in Iran. Arch Iran Med; 2010 Sep;13(5):417-9
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  • [Title] Post-transplantation lymphoproliferative disorder after liver transplantation: report of 5 cases among more than 550 liver transplants in Iran.
  • BACKGROUND: Post-transplantation lymphoproliferative disorders (PTLD) are a spectrum of diseases defined as polyclonal or monoclonal proliferations of lymphocytes which occur after solid organ transplants.
  • In this study, we report our first experiences with PTLD following liver transplantation in Iran.
  • METHODS: We retrospectively analyzed five cases of PTLD which followed liver transplantation among more than 550 liver transplants in our center.
  • All cases, except for one, developed PTLD during the first year following liver transplantation.
  • RESULTS: Patients were diagnosed as PTLD, B-cell, MALT and Hodgkin-like (according to the WHO classification of PTLD).
  • The three pediatric patients died despite discontinuation of immunosuppressive drugs and chemotherapy.
  • CONCLUSION: The incidence of PTLD in our center is lower than previous reports from other centers (0.9%), with a 60% mortality rate and worse prognosis in the pediatric age group.
  • [MeSH-major] Liver Transplantation / adverse effects. Liver Transplantation / immunology. Lymphoma / etiology
  • [MeSH-minor] Adolescent. Adult. Antineoplastic Agents, Hormonal / therapeutic use. Antineoplastic Agents, Phytogenic / therapeutic use. Child, Preschool. Cyclophosphamide / therapeutic use. Cyclosporine / therapeutic use. Fatal Outcome. Female. Herpesvirus 4, Human / isolation & purification. Humans. Immunosuppression. Immunosuppressive Agents / therapeutic use. Incidence. Infant. Iran / epidemiology. Male. Mycophenolic Acid / analogs & derivatives. Mycophenolic Acid / therapeutic use. Prednisolone / therapeutic use. Tacrolimus / therapeutic use. Vincristine / therapeutic use

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  • (PMID = 20804309.001).
  • [ISSN] 1735-3947
  • [Journal-full-title] Archives of Iranian medicine
  • [ISO-abbreviation] Arch Iran Med
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Iran
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; 0 / Antineoplastic Agents, Phytogenic; 0 / Immunosuppressive Agents; 5J49Q6B70F / Vincristine; 83HN0GTJ6D / Cyclosporine; 8N3DW7272P / Cyclophosphamide; 9242ECW6R0 / mycophenolate mofetil; 9PHQ9Y1OLM / Prednisolone; HU9DX48N0T / Mycophenolic Acid; WM0HAQ4WNM / Tacrolimus
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7. Makis W, Lisbona R, Derbekyan V: Hodgkin lymphoma post-transplant lymphoproliferative disorder following pediatric renal transplant: serial imaging with F-18 FDG PET/CT. Clin Nucl Med; 2010 Sep;35(9):704-5
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  • [Title] Hodgkin lymphoma post-transplant lymphoproliferative disorder following pediatric renal transplant: serial imaging with F-18 FDG PET/CT.
  • Post-transplant lymphoproliferative disorder (PTLD) occurs in 1.2% of pediatric renal transplant patients, and is frequently Epstein-Barr Virus mediated.
  • Hodgkin Lymphoma PTLD is the rarest of the 4 types of PTLDs recognized by the World Health Organization, with an incidence of <4% of all PTLD patients.
  • It has a distinct clinical course and treatment from all other types of PTLD.
  • This is a case of a 16-year-old girl who had a renal transplant in 2000 due to Moya Moya disease.
  • Biopsy of a supraclavicular node identified Hodgkin Lymphoma PTLD.
  • The patient was treated with chemotherapy and reimaged, showing excellent response to therapy.
  • In contrast, classic PTLD is treated by withdrawal of immunosuppression and administration of Rituximab.
  • F-18 FDG PET/CT is known to be very useful in the staging and monitoring of response to therapy in the setting of classic PTLD.
  • In this case, serial F-18 FDG PET/CT scans proved very useful in the evaluation and follow-up of the rare and distinct Hodgkin Lymphoma PTLD subtype.
  • [MeSH-major] Fluorodeoxyglucose F18. Hodgkin Disease / etiology. Hodgkin Disease / radionuclide imaging. Kidney Transplantation / adverse effects. Positron-Emission Tomography. Tomography, X-Ray Computed

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  • (PMID = 20706047.001).
  • [ISSN] 1536-0229
  • [Journal-full-title] Clinical nuclear medicine
  • [ISO-abbreviation] Clin Nucl Med
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0Z5B2CJX4D / Fluorodeoxyglucose F18
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8. Pitman SD, Huang Q, Zuppan CW, Rowsell EH, Cao JD, Berdeja JG, Weiss LM, Wang J: Hodgkin lymphoma-like posttransplant lymphoproliferative disorder (HL-like PTLD) simulates monomorphic B-cell PTLD both clinically and pathologically. Am J Surg Pathol; 2006 Apr;30(4):470-6
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  • [Title] Hodgkin lymphoma-like posttransplant lymphoproliferative disorder (HL-like PTLD) simulates monomorphic B-cell PTLD both clinically and pathologically.
  • Although Hodgkin lymphoma-like posttransplantation lymphoproliferative disorder (HL-like PTLD) has been grouped with classic Hodgkin lymphoma type PTLD (HL-PTLD), controversy remains as to whether it is truly a form of HL or whether it should be more appropriately classified as a form of B-cell PTLD.
  • Because only few cases of HL-like PTLD have been reported, their pathologic nature and clinical behavior have not been well defined.
  • This report characterized 5 cases of HL-like PTLD with respect to their immunophenotype, EBV status, clonality, and clinical outcome.
  • PTLD developed from 4 months to 6 years following solid organ transplantation (3 hearts, 1 kidney, 1 liver), and involved both nodal and extranodal sites.
  • All patients were managed by initial reduction/withdrawal of immunosuppression, with 2 also receiving chemotherapy for non-HL.
  • We conclude that, although HL-like PTLD morphologically simulates classic HL PTLD, there are important immunophenotypic, molecular genetic, and clinical differences, suggesting it is in fact most often a B-cell PTLD.
  • Distinction between HL and HL-like PTLD may be important for clinical management and prognosis.
  • [MeSH-major] B-Lymphocytes / pathology. Hodgkin Disease / etiology. Hodgkin Disease / pathology. Lymphoproliferative Disorders / etiology. Lymphoproliferative Disorders / pathology. Organ Transplantation / adverse effects

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  • (PMID = 16625093.001).
  • [ISSN] 0147-5185
  • [Journal-full-title] The American journal of surgical pathology
  • [ISO-abbreviation] Am. J. Surg. Pathol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / DNA, Neoplasm; 0 / Epstein-Barr virus encoded RNA 1; 0 / RNA, Viral
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9. Smets F, Vajro P, Cornu G, Reding R, Otte JB, Sokal E: Indications and results of chemotherapy in children with posttransplant lymphoproliferative disease after liver transplantation. Transplantation; 2000 Mar 15;69(5):982-4
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  • [Title] Indications and results of chemotherapy in children with posttransplant lymphoproliferative disease after liver transplantation.
  • Among 39 posttransplant lymphoproliferative diseases (PTLD) in a cohort of 450 pediatric liver transplant recipients, 3 had a malignant lymphoma, unresponsive to arrest of immunosuppression and to gancyclovir, interferon, and anti-interleukin 6 antibodies.
  • Lymphoma appeared 20, 46, and 96 months posttransplantation and 16, 43, and 90 months after primary Epstein-Barr virus infection.
  • In one case, the patient had histological progression from plasmacytic hyperplasia PTLD, concomitant with symptomatic primary infection, to Burkitt-like lymphoma 43 months later.
  • These three patients received five courses of chemotherapy, after a cyclophosphamide, doxorubicin, vincristine, and prednisone regimen for Burkitt-like or LH 89 scheme for Hodgkin-like PTLDs.
  • Chemotherapy was well tolerated, and all three were free of disease and without immunosuppression 19, 14, and 4 months after chemotherapy.
  • In Burkitt-like or Hodgkin-like PTLDs, immunomodulatory or antiviral drugs were inefficient.
  • Chemotherapy is indicated and can be safely and successfully used.
  • [MeSH-major] Liver Transplantation. Lymphoproliferative Disorders / drug therapy. Lymphoproliferative Disorders / etiology. Postoperative Complications
  • [MeSH-minor] Antineoplastic Agents / administration & dosage. Antineoplastic Agents, Alkylating / administration & dosage. Antineoplastic Agents, Hormonal / administration & dosage. Antineoplastic Agents, Phytogenic / administration & dosage. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Burkitt Lymphoma / drug therapy. Burkitt Lymphoma / etiology. Child. Child, Preschool. Cyclophosphamide / administration & dosage. Doxorubicin / administration & dosage. Epstein-Barr Virus Infections / etiology. Female. Hodgkin Disease / drug therapy. Hodgkin Disease / etiology. Humans. Prednisone / adverse effects. Vincristine / administration & dosage

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  • (PMID = 10755561.001).
  • [ISSN] 0041-1337
  • [Journal-full-title] Transplantation
  • [ISO-abbreviation] Transplantation
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] UNITED STATES
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Antineoplastic Agents, Alkylating; 0 / Antineoplastic Agents, Hormonal; 0 / Antineoplastic Agents, Phytogenic; 5J49Q6B70F / Vincristine; 80168379AG / Doxorubicin; 8N3DW7272P / Cyclophosphamide; VB0R961HZT / Prednisone
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10. Colleoni GW, Oliveira JS, Borducchi DM, Fernandes MA, Da Silva HT, Alves AC, De Franco MF, Kerbauy J, Pestana JO: Post-transplant lymphoproliferative disorders (PTLD) after renal transplantation: management and evolution of seven cases among 1002 renal transplants in São Paulo, Brazil. Leuk Lymphoma; 2000 Sep;39(1-2):145-50
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  • [Title] Post-transplant lymphoproliferative disorders (PTLD) after renal transplantation: management and evolution of seven cases among 1002 renal transplants in São Paulo, Brazil.
  • We reported seven cases (0.7%) of PTLD among 1002 renal transplants performed at Renal Transplant Service from Hospital São Paulo-Universidade Federal de São Paulo/Escola Paulista de Medicina, São Paulo, Brazil, between 1976 and 1997.
  • Four patients received cadaveric, two received related and one received unrelated renal transplant.
  • PTLD occurred after a median latency period of 36 months (ranging from 5 to 84 months).
  • In situ hybridization for EBER1 was performed in five patients and molecular evidence of EBV was found in 3 cases (two DLCL and one lymphoplasmocytoid lymphoma).
  • All patients were treated with immunosuppression withdrawal, four patients received anthracyclin-based chemotherapy for control of localized or systemic clonal disease and three were treated with resection of primary PTLD.
  • Four of seven patients (57%) are in complete remission 11, 20, 25 and 79 months after PTLD onset.
  • One patient lost follow-up and two patients died due to lymphoma relapse, respectively 4 and 10 months after completion of treatment.
  • 1) immunosuppression withdrawal is not necessarily associated with loss of renal transplant and can be used as the only treatment for polyclonal PTLD;.
  • 2) chemotherapy can simultaneously lead to clonal PTLD remission and periodic immunosuppression, avoiding graft rejection after immunosuppression withdrawal.
  • [MeSH-major] Kidney Transplantation / adverse effects. Lymphoproliferative Disorders / etiology
  • [MeSH-minor] Adult. Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Antineoplastic Combined Chemotherapy Protocols / toxicity. Brazil. Combined Modality Therapy. Disease Management. Epstein-Barr Virus Infections / chemically induced. Epstein-Barr Virus Infections / complications. Female. Follow-Up Studies. Humans. Immunosuppressive Agents / administration & dosage. Immunosuppressive Agents / toxicity. Lymphoma, Non-Hodgkin / chemically induced. Lymphoma, Non-Hodgkin / etiology. Lymphoma, Non-Hodgkin / virology. Male. Middle Aged. RNA, Viral / blood. Treatment Outcome

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  • (PMID = 10975393.001).
  • [ISSN] 1042-8194
  • [Journal-full-title] Leukemia & lymphoma
  • [ISO-abbreviation] Leuk. Lymphoma
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] SWITZERLAND
  • [Chemical-registry-number] 0 / Epstein-Barr virus encoded RNA 1; 0 / Immunosuppressive Agents; 0 / RNA, Viral
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11. Ranganathan S, Webber S, Ahuja S, Jaffe R: Hodgkin-like posttransplant lymphoproliferative disorder in children: does it differ from posttransplant Hodgkin lymphoma? Pediatr Dev Pathol; 2004 Jul-Aug;7(4):348-60
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  • [Title] Hodgkin-like posttransplant lymphoproliferative disorder in children: does it differ from posttransplant Hodgkin lymphoma?
  • Most post-transplant lymphoproliferative disorders (PTLD) are polymorphic in appearance; some are monomorphic and can resemble conventional malignant lymphomas.
  • PTLD that resembles Hodgkin lymphoma has been reported infrequently.
  • We herein report seven cases of PTLD that have large numbers of Reed-Sternberg-like (RS-like) cells and highlight differences in the phenotype of these cases that may distinguish Hodgkin-like PTLD (HL-PTLD) from true Hodgkin lymphoma/disease (HD).
  • All patients were in the second decade of life and were 8 months to 13 years following transplant.
  • HL-PTLD involves lymph nodes that contain a mixed population of small to intermediate-sized lymphocytes with large mononuclear and occasionally binucleate RS-like cells.
  • The large cells of HL-PTLD are pleomorphic B cells that react strongly for CD20 and/or CD79a, express CD30, but are usually negative for CD15 and have few mitoses.
  • A single case of true Hodgkin lymphoma has highly atypical RS-like cells that contain numerous mitoses, does not have CD20 or CD79a reactivity, has CD15 and CD30 staining, and the EBER-1 probe is confined to the large cells only.
  • All patients were managed by withdrawal of immunosuppression and variably treated with either antiviral or anti-CD20 monoclonal antibody, or with chemotherapy.
  • A unique instance of evolution from a HL-PTLD to true HD is also illustrated.
  • In conclusion, HL-PTLD and HD appear to be two related but immunophenotypically and biologically distinct forms of lymphoproliferation in post-transplant patients and may require different protocols for their management.
  • [MeSH-major] Hodgkin Disease / etiology. Hodgkin Disease / pathology. Lymphoproliferative Disorders / etiology. Lymphoproliferative Disorders / pathology. Organ Transplantation / adverse effects

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  • [Copyright] Copyright 2004 Society for Pediatric Pathology
  • (PMID = 14564542.001).
  • [ISSN] 1093-5266
  • [Journal-full-title] Pediatric and developmental pathology : the official journal of the Society for Pediatric Pathology and the Paediatric Pathology Society
  • [ISO-abbreviation] Pediatr. Dev. Pathol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Epstein-Barr virus encoded RNA 1; 0 / RNA, Viral
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12. Rohr JC, Wagner HJ, Lauten M, Wacker HH, Jüttner E, Hanke C, Pohl M, Niemeyer CM: Differentiation of EBV-induced post-transplant Hodgkin lymphoma from Hodgkin-like post-transplant lymphoproliferative disease. Pediatr Transplant; 2008 Jun;12(4):426-31
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  • [Title] Differentiation of EBV-induced post-transplant Hodgkin lymphoma from Hodgkin-like post-transplant lymphoproliferative disease.
  • The development of lymphomas after SOT is a well-known complication of the immunosuppressive therapy necessary to prevent graft rejection.
  • Differentiating PTLD from malignant lymphomas, especially HL can be challenging.
  • We report on two patients, who developed EBV-associated lymphomas several years after SOT.
  • A histological examination of lymph nodes led to a diagnosis of HL in both patients, who were started on chemotherapy according to current treatment protocols.
  • In this patient, the EBV expression profile revealed a latency type III suggesting the diagnosis of Hodgkin-like PTLD.
  • The other patient required six courses of chemotherapy plus radiotherapy to reach a complete remission.
  • In his tumor cells, a restricted EBV-latency type II pattern was found, suggesting a diagnosis of classical HL.
  • These two cases demonstrate that in post-transplant lymphomas with histological features of HL, an analysis of the expression pattern of EBV proteins might aid in the differentiation between PTLD and HL.
  • [MeSH-major] Epstein-Barr Virus Infections / complications. Herpesvirus 4, Human / metabolism. Hodgkin Disease / etiology. Hodgkin Disease / virology. Kidney Transplantation / adverse effects. Liver Transplantation / adverse effects. Lymphoproliferative Disorders / etiology. Lymphoproliferative Disorders / virology
  • [MeSH-minor] Adolescent. Antineoplastic Agents / therapeutic use. Child. Cyclosporine / adverse effects. Diagnosis, Differential. Humans. Immunosuppressive Agents / adverse effects. Lymph Nodes / pathology. Male


13. Bitzan M, Ouahed JD, Carpineta L, Bernard C, Bell LE: Cryptogenic organizing pneumonia after rituximab therapy for presumed post-kidney transplant lymphoproliferative disease. Pediatr Nephrol; 2010 Jun;25(6):1163-7
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  • [Title] Cryptogenic organizing pneumonia after rituximab therapy for presumed post-kidney transplant lymphoproliferative disease.
  • We describe an 11-year-old girl with Epstein-Barr virus (EBV) reactivation/presumed post-transplant lymphoproliferative disease (PTLD) 15 months after undergoing a deceased donor kidney transplantation.
  • Treatment with reduced immunosuppression, ganciclovir, and cytomegalovirus immunoglobulin was complicated by severe graft rejection, prompting therapy with methylprednisolone, anti-thymocyte globulin and four weekly doses of rituximab (total 1500 mg/m(2)).
  • When the lactate dehydrogenase and uric acid levels rose 10 weeks after the first rituximab infusion and bilateral pulmonary nodules were detected by computerized tomography, recurrence of PTLD was suspected.
  • Four years later, the patient was diagnosed with classical Hodgkin lymphoma-type PTLD with multiple pulmonary and abdominal nodes.
  • This first report of rituximab-associated, pediatric COP highlights the risk of pulmonary complications after treatment with B-cell depleting agents in solid organ transplant recipients, and the importance of a histopathologic diagnosis and vigilant follow-up of such lesions.
  • [MeSH-major] Antibodies, Monoclonal / adverse effects. Bronchiolitis Obliterans / chemically induced. Immunologic Factors / adverse effects. Kidney Transplantation / adverse effects. Lymphoproliferative Disorders / drug therapy
  • [MeSH-minor] Antibodies, Monoclonal, Murine-Derived. Child. Epstein-Barr Virus Infections / complications. Female. Graft Rejection / pathology. Graft Rejection / therapy. Humans. Rituximab

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  • (PMID = 20140460.001).
  • [ISSN] 1432-198X
  • [Journal-full-title] Pediatric nephrology (Berlin, Germany)
  • [ISO-abbreviation] Pediatr. Nephrol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Antibodies, Monoclonal; 0 / Antibodies, Monoclonal, Murine-Derived; 0 / Immunologic Factors; 4F4X42SYQ6 / Rituximab
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14. Kudo K, Sonoda M, Sugimoto K, Koike M: [Cutaneous non-Hodgkin lymphoma of the leg occurring 11 years after renal transplantation]. Rinsho Ketsueki; 2009 Feb;50(2):107-9
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  • [Title] [Cutaneous non-Hodgkin lymphoma of the leg occurring 11 years after renal transplantation].
  • She received immunosuppressive therapy postoperatively.
  • Skin lesion was recognized on the left leg in April 2002 and skin biopsy demonstrated diffuse large B cell lymphoma in March 2006.
  • EBV-LMP, EBNA-2 and EBER were positive and she was diagnosed as having EBV-related posttransplant lymphoproliferative disease (PTLD).
  • Radiation therapy and rituximab therapy were administered.
  • We reduced the dose of immunosuppressive drug and performed debridement of the ulcer, which responded well to treatment.
  • PTLD presenting with skin involvement rarely manifests as lesions, and such lesions develop slowly, when they occur.
  • PTLD presenting with skin involvement after transplantation must be treated.
  • [MeSH-major] Epstein-Barr Virus Infections / complications. Kidney Transplantation / adverse effects. Lymphoma, Large B-Cell, Diffuse / etiology. Lymphoproliferative Disorders / etiology. Skin Neoplasms / etiology
  • [MeSH-minor] Debridement. Female. Humans. Immunosuppressive Agents / administration & dosage. Middle Aged. Polycystic Kidney Diseases / surgery. Time Factors


15. Evens AM, Roy R, Sterrenberg D, Moll MZ, Chadburn A, Gordon LI: Post-transplantation lymphoproliferative disorders: diagnosis, prognosis, and current approaches to therapy. Curr Oncol Rep; 2010 Nov;12(6):383-94
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  • [Title] Post-transplantation lymphoproliferative disorders: diagnosis, prognosis, and current approaches to therapy.
  • Post-transplantation lymphoproliferative disorders (PTLD) are a heterogenous group of abnormal lymphoid proliferations that occur after solid organ transplant (SOT) or hematopoietic transplantation.
  • The majority of cases are B-cell, although 10-15% are of T-cell origin or rarely Hodgkin lymphoma.
  • Recent SOT series suggest PTLD occurs at a median of 36-40 months after transplant.
  • Since the first report over 40 years ago, PTLD has remained one of the most morbid complications associated with SOT.
  • However, recent data suggests improved survival in the modern era, especially with the integration of early rituximab-based therapy.
  • These studies utilized first line rituximab (+/- chemotherapy) together with reduced immune suppression (RI) for monomorphic and polymorphic PTLD.
  • It will be critical in future studies to determine which PTLDs are most amenable to initial therapy with RI alone, versus RI/rituximab, versus RI/rituximab/chemotherapy.
  • Additionally, novel therapeutics, such as adoptive immunotherapy, should continue to be explored.
  • [MeSH-major] Antibodies, Monoclonal, Murine-Derived / administration & dosage. Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Immunosuppression / adverse effects. Lymphoproliferative Disorders / pathology. Lymphoproliferative Disorders / therapy
  • [MeSH-minor] B-Lymphocytes / immunology. B-Lymphocytes / pathology. Clinical Trials as Topic. Combined Modality Therapy. Disease Progression. Disease-Free Survival. Drug Administration Schedule. Epstein-Barr Virus Infections / diagnosis. Epstein-Barr Virus Infections / therapy. Herpesvirus 4, Human. Humans. Immunotherapy, Adoptive. Morbidity. Organ Transplantation / adverse effects. Risk Factors. Rituximab. Survival Rate. T-Lymphocytes / immunology. T-Lymphocytes / pathology. Tissue Transplantation / adverse effects. Treatment Outcome

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  • (PMID = 20963522.001).
  • [ISSN] 1534-6269
  • [Journal-full-title] Current oncology reports
  • [ISO-abbreviation] Curr Oncol Rep
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antibodies, Monoclonal, Murine-Derived; 4F4X42SYQ6 / Rituximab
  •  go-up   go-down


16. Bueno J, Ramil C, Somoza I, Sanchez-Galindo A, Solar A, Arnal F, Alvarez A, Sánchez-Mozo P, Gómez M: Treatment of monomorphic B-cell lymphoma with rituximab after liver transplantation in a child. Pediatr Transplant; 2003 Apr;7(2):153-6
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  • [Title] Treatment of monomorphic B-cell lymphoma with rituximab after liver transplantation in a child.
  • Rituximab, a monoclonal antibody directed against the B-cell specific CD20 antigen has been used with success in post-transplant lymphoproliferative disorder (PTLD) of B-cell phenotype.
  • However, the use of such drug in children with liver transplantation and PTLD is very limited.
  • We report a 2-yr-old liver transplant recipient with monomorphic non-Hodgkin lymphoma of B-cell origin.
  • The lymphoma did not respond to immunosuppression withdrawal, with a subsequent allograft rejection.
  • Despite resumption of immunosuppression and rejection treatment, the lymphoma was successfully treated with rituximab.
  • [MeSH-major] Antibodies, Monoclonal / therapeutic use. Liver Transplantation. Lymphoma, B-Cell / drug therapy

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  • (PMID = 12654058.001).
  • [ISSN] 1397-3142
  • [Journal-full-title] Pediatric transplantation
  • [ISO-abbreviation] Pediatr Transplant
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Denmark
  • [Chemical-registry-number] 0 / Antibodies, Monoclonal; 0 / Antibodies, Monoclonal, Murine-Derived; 4F4X42SYQ6 / Rituximab
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17. Bosly A, Keating MJ, Stasi R, Bradstock K: Rituximab in B-cell disorders other than non-Hodgkin's lymphoma. Anticancer Drugs; 2002 Nov;13 Suppl 2:S25-33
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  • [Title] Rituximab in B-cell disorders other than non-Hodgkin's lymphoma.
  • Rituximab has demonstrated efficacy as monotherapy and in combination with chemotherapy in the treatment of both indolent and aggressive non-Hodgkin's lymphoma (NHL).
  • Rituximab treatment results in rapid depletion of B-cells and this has led to the consideration of other B-cell disorders as candidates for rituximab therapy.
  • Recent studies have demonstrated the efficacy of rituximab in a variety of such disorders, including chronic lymphocytic leukemia (CLL), post-transplant lymphoproliferative disorder (PTLD), Waldenström's macroglobulinemia (WM), multiple myeloma (MM), idiopathic thrombocytopenic purpura (ITP), hairy-cell leukemia (HCL) and cold agglutinin disease (CAD).
  • In patients with CLL, increasing the dose and/or frequency of rituximab treatment has given improved response rates compared with the standard dose schedule used in NHL, and combination immunochemotherapy has yielded an overall response rate of 92% (with a 60% complete response rate).
  • Clinical trials have also demonstrated evidence of efficacy for rituximab in PTLD, WM and relapsed or refractory ITP.
  • Available data thus indicate that rituximab can be an effective therapy in a wide range of CD20+ lymphoid disorders.
  • [MeSH-major] Antibodies, Monoclonal / therapeutic use. B-Lymphocytes / pathology. Hematologic Diseases / drug therapy. Lymphoproliferative Disorders / drug therapy
  • [MeSH-minor] Anemia, Hemolytic, Autoimmune / drug therapy. Antibodies, Monoclonal, Murine-Derived. Antineoplastic Agents / therapeutic use. Clinical Trials as Topic. Humans. Leukemia, Lymphocytic, Chronic, B-Cell / drug therapy. Lymphoma, Non-Hodgkin / drug therapy. Organ Transplantation / adverse effects. Paraproteinemias / drug therapy. Purpura, Thrombocytopenic, Idiopathic / drug therapy. Rituximab

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  • [CommentIn] Curr Rheumatol Rep. 2003 Oct;5(5):381-2 [12967521.001]
  • (PMID = 12710588.001).
  • [ISSN] 0959-4973
  • [Journal-full-title] Anti-cancer drugs
  • [ISO-abbreviation] Anticancer Drugs
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antibodies, Monoclonal; 0 / Antibodies, Monoclonal, Murine-Derived; 0 / Antineoplastic Agents; 4F4X42SYQ6 / Rituximab
  • [Number-of-references] 43
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18. Taj MM, Messahel B, Mycroft J, Pritchard-Jones K, Baker A, Height S, Hadzic N, Pinkerton CR: Efficacy and tolerability of high-dose methotrexate in central nervous system positive or relapsed lymphoproliferative disease following liver transplant in children. Br J Haematol; 2008 Jan;140(2):191-6
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Efficacy and tolerability of high-dose methotrexate in central nervous system positive or relapsed lymphoproliferative disease following liver transplant in children.
  • Childhood post-transplant lymphoproliferative disease (PTLD) is a heterogeneous condition in which treatment varies, from the reduction of immunosuppression to moderately intensive chemotherapy.
  • While low-dose chemotherapy/rituximab has been found to be effective, moderately intensive chemotherapy is required for patients who relapse, have classic non-Hodgkin lymphoma or have fulminant PTLD.
  • However, there are no data in the literature regarding its safety in post-liver transplant patients.
  • We describe four cases of high-grade lymphomas (three diffuse large B cell and one T-cell lymphoblastic), post-liver transplant, for which chemotherapy including high-dose Mtx (HDMTX) was the treatment of choice.
  • The treatment was well tolerated and all four patients had a good response.
  • One case of central nervous system (CNS) diffuse large B-cell lymphoma was treated with HDMTX alone.
  • We conclude that, in the absence of significant organ damage, HDMTX can safely be given to liver transplant patients, but should only be administered in specialist oncology units.
  • Proof of effectiveness as a single agent in CNS lymphoma needs further studies.
  • [MeSH-major] Antimetabolites, Antineoplastic / therapeutic use. Central Nervous System Neoplasms / drug therapy. Liver Transplantation. Lymphoma, Non-Hodgkin / drug therapy. Methotrexate / therapeutic use
  • [MeSH-minor] Child. Child, Preschool. Drug-Induced Liver Injury. Humans. Male. Postoperative Complications / drug therapy. Tomography, X-Ray Computed

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  • (PMID = 18173755.001).
  • [ISSN] 1365-2141
  • [Journal-full-title] British journal of haematology
  • [ISO-abbreviation] Br. J. Haematol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antimetabolites, Antineoplastic; YL5FZ2Y5U1 / Methotrexate
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19. Dharnidharka VR, Douglas VK, Hunger SP, Fennell RS: Hodgkin's lymphoma after post-transplant lymphoproliferative disease in a renal transplant recipient. Pediatr Transplant; 2004 Feb;8(1):87-90
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Hodgkin's lymphoma after post-transplant lymphoproliferative disease in a renal transplant recipient.
  • Lymphoid malignancies such as post-transplant lymphoproliferative disease (PTLD) are a major complication of solid organ transplantation.
  • Hodgkin's lymphoma (HL) is not part of the typical spectrum of PTLD, but has rarely been reported as a separate complication.
  • We report a case of HL occurring after previous PTLD in a renal transplant recipient.
  • A 9-yr-old girl with end-stage autosomal recessive polycystic kidney disease received a cadaveric renal transplant at 1 yr of age.
  • She developed polymorphic PTLD localized to the bone marrow at 6 yr post-transplant.
  • No chemotherapy or anti-B cell antibody was administered.
  • The PTLD resolved and kidney graft function remained stable.
  • At 9 yr post-transplant, she presented again with fever of 2 wk duration, associated with enlarged lymph nodes at multiple sites.
  • She was treated with standard combination chemotherapy for HL with COPP/ABV.
  • RS like cells have been reported in the setting of PTLD, but these cells possess an activated B cell phenotype, are EBV negative and CD15 negative.
  • True HL following PTLD has been reported in only three previous cases, with good response to standard chemotherapy in each.
  • [MeSH-major] Epstein-Barr Virus Infections / complications. Hodgkin Disease / virology. Immunosuppression / adverse effects. Kidney Transplantation. Lymphoproliferative Disorders / etiology


20. Long HM, Parsonage G, Fox CP, Lee SP: Immunotherapy for Epstein-Barr virus-associated malignancies. Drug News Perspect; 2010 May;23(4):221-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • Epstein-Barr virus (EBV) is present in the malignant cells of several human cancers including post-transplant lymphoproliferative disease (PTLD), Hodgkin's lymphoma, nasopharyngeal carcinoma, natural killer/T lymphomas and Burkitt's lymphoma.
  • Accordingly, EBV-associated malignancies represent good candidates for a T-cell-based therapy and provide an important model for developing such therapies for other human cancers.
  • This review summarizes the impressive results seen with T-cell therapy for PTLD and discusses, in the light of recent technological advances, the prospects for developing more effective approaches for other EBV-associated cancers.
  • [MeSH-major] Epstein-Barr Virus Infections / complications. Hematopoietic Stem Cell Transplantation / adverse effects. Immunotherapy. Lymphoproliferative Disorders / therapy. Neoplasms / therapy. Organ Transplantation / adverse effects. T-Lymphocytes, Cytotoxic / immunology

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  • [Copyright] Copyright 2010 Prous Science, S.A.U. or its licensors. All rights reserved.
  • (PMID = 20520851.001).
  • [ISSN] 0214-0934
  • [Journal-full-title] Drug news & perspectives
  • [ISO-abbreviation] Drug News Perspect.
  • [Language] eng
  • [Grant] United Kingdom / Cancer Research UK / /
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] Spain
  • [Chemical-registry-number] 0 / Receptors, Antigen, T-Cell
  • [Number-of-references] 77
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21. Soler MJ, Puig JM, Mir M, Parrilla J, Pedro C, Salar A, Serrano S, Lloveras J: Posttransplant lymphoproliferative disease: treatment and outcome in renal transplant recipients. Transplant Proc; 2003 Aug;35(5):1709-13
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Posttransplant lymphoproliferative disease: treatment and outcome in renal transplant recipients.
  • Posttransplant lymphoproliferative disorders (PTLD) are a heterogeneous group of lymphoid diseases that occur after solid organ and bone marrow transplantation.
  • We performed a retrospective study to assess the incidence, response to treatment, and patient and graft survival after PTLD.
  • PATIENTS: Between January 1980 and December 2002, 1.96% (n=10) of 509 renal transplant recipients developed PTLD.
  • They were classified into four groups based upon the type of PTLD: group I, early lesion (n=1); group II, polymorphic PTLD (n=1); group III, monomorphic PTLD (n=7) including five non-Hodgkin lymphoma [NHL] and two Burkitt (BL); and group IV, Hodgkin lymphoma (HL) (n=1).
  • The mean time from transplantation to diagnosis was 77 months (range 4-138).
  • Treatment was individualized according to PTLD type: for group I, immunosuppression reduction (IR); group II, IR plus acyclovir; group III, withdrawal or IR plus chemotherapy and/or surgery in all but one patient who was also treated with anti-CD20 monoclonal antibody and radiotherapy.
  • For group IV, treatment was IR plus radiotherapy.
  • CONCLUSIONS: The incidence of PTLD in our center was 1.96%.
  • Patient survival after PTLD was 90%, with 60% maintaining allograft function.
  • Individualized treatment according to extension, histology, and location is mandatory to obtain a high survival rate.
  • [MeSH-major] Graft Survival / physiology. Kidney Transplantation / adverse effects. Lymphoproliferative Disorders / epidemiology
  • [MeSH-minor] Adult. Aged. Drug Therapy, Combination. Female. Follow-Up Studies. Humans. Immunosuppressive Agents / therapeutic use. Male. Middle Aged. Retrospective Studies. Survival Analysis. Time Factors. Treatment Outcome

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  • (PMID = 12962767.001).
  • [ISSN] 0041-1345
  • [Journal-full-title] Transplantation proceedings
  • [ISO-abbreviation] Transplant. Proc.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Immunosuppressive Agents
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22. Halkos ME, Miller JI, Mann KP, Miller DL, Gal AA: Thoracic presentations of posttransplant lymphoproliferative disorders. Chest; 2004 Dec;126(6):2013-20
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  • [Title] Thoracic presentations of posttransplant lymphoproliferative disorders.
  • BACKGROUND: Posttransplant lymphoproliferative disorders (PTLDs) are rare complications following transplantation.
  • METHODS: Eleven cases of PTLD with a primary thoracic presentation were identified among 3,085 solid-organ transplant patients and 1,662 bone marrow transplant patients from 1990 to 2001.
  • The time to presentation ranged from 1 to 97 months (median time, 8 months).
  • Six patients developed PTLD within 1 year of undergoing transplantation.
  • Pathologic analysis revealed monomorphic PTLD (ie, diffuse large B-cell lymphoma) in seven patients, polymorphic PTLD in two patients, anaplastic large cell lymphoma in one patient, and Hodgkin lymphoma in one patient.
  • All patients were initially treated with a reduction in immunosuppression therapy, and six patients (55%) received adjuvant chemotherapy.
  • Four patients died from complications of PTLD (kidney, two patients; heart, one patient; bone marrow, one patient), and three patients (all lung transplant recipients) died from rejection or infectious complications.
  • CONCLUSIONS: Thoracic PTLD can occur in any transplant patient and must be regarded as a potentially fatal complication in the immunosuppressed patient.
  • Heart and lung allograft recipients have the worst prognosis because of the mortality that accompanies rejection with subtherapeutic immunosuppression therapy.
  • Earlier diagnosis and improvements in immunosuppression and chemotherapy may improve survival for these inherently high-risk patients.
  • [MeSH-major] Lymphoproliferative Disorders / diagnosis. Thoracic Diseases / diagnosis. Transplantation / adverse effects
  • [MeSH-minor] Adult. Antibodies, Viral / analysis. Cytomegalovirus / isolation & purification. Female. Herpesvirus 4, Human / isolation & purification. Humans. Lymphoma / diagnosis. Lymphoma / etiology. Lymphoma / therapy. Lymphoma / virology. Male. Middle Aged

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  • (PMID = 15596707.001).
  • [ISSN] 0012-3692
  • [Journal-full-title] Chest
  • [ISO-abbreviation] Chest
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antibodies, Viral
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23. De Angelis B, Dotti G, Quintarelli C, Huye LE, Zhang L, Zhang M, Pane F, Heslop HE, Brenner MK, Rooney CM, Savoldo B: Generation of Epstein-Barr virus-specific cytotoxic T lymphocytes resistant to the immunosuppressive drug tacrolimus (FK506). Blood; 2009 Nov 26;114(23):4784-91
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Generation of Epstein-Barr virus-specific cytotoxic T lymphocytes resistant to the immunosuppressive drug tacrolimus (FK506).
  • Adoptive transfer of autologous Epstein-Barr virus-specific cytotoxic T lymphocytes (EBV-CTLs) to solid organ transplant (SOT) recipients has been shown safe and effective for the treatment of EBV-associated posttransplantation lymphoproliferative disorders (PTLDs).
  • SOT recipients, however, require the continuous administration of immunosuppressive drugs to prevent graft rejection, and these agents may significantly limit the long-term persistence of transferred EBV-CTLs, precluding their use as prophylaxis.
  • These cells continue to expand in the presence of the drug without measurable impairment of their antigen specificity or cytotoxic activity.
  • We confirmed their FK506 resistance and anti-PTLD activity in vivo using a xenogenic mouse model, suggesting that the proposed strategy may be of value to enhance EBV-specific immune surveillance in patients at high risk of PTLD after transplantation.

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  • [Cites] Transpl Infect Dis. 2009 Jun;11(3):195-202 [19228345.001]
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  • [CommentIn] Blood. 2009 Nov 26;114(23):4759-60 [19965696.001]
  • (PMID = 19759356.001).
  • [ISSN] 1528-0020
  • [Journal-full-title] Blood
  • [ISO-abbreviation] Blood
  • [Language] ENG
  • [Grant] United States / NCI NIH HHS / CA / P50 CA126752-04; United States / NCI NIH HHS / CA / P50 CA126752; United States / NCI NIH HHS / CA / P01 CA094237-08; None / None / / P01 CA094237-08; United States / NCI NIH HHS / CA / R01 CA131027; United States / NCI NIH HHS / CA / P01 CA094237; United States / NCI NIH HHS / CA / CA126752-04
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antigens, Viral; 0 / Immunosuppressive Agents; 0 / RNA, Messenger; 0 / RNA, Small Interfering; 0 / Recombinant Fusion Proteins; EC 2.7.11.1 / Ribosomal Protein S6 Kinases; EC 5.2.1.- / Tacrolimus Binding Protein 1A; WM0HAQ4WNM / Tacrolimus
  • [Other-IDs] NLM/ PMC2786289
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24. Aversa SM, Stragliotto S, Marino D, Calabrese F, Rigotti P, Marchini F, Gambino A, Feltrin G, Boso C, Canova F, Soldà C, Mazzarotto R, Burra P: Post-transplant lymphoproliferative disorders after heart or kidney transplantation at a single centre: presentation and response to treatment. Acta Haematol; 2008;120(1):36-46
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Post-transplant lymphoproliferative disorders after heart or kidney transplantation at a single centre: presentation and response to treatment.
  • Post-transplant lymphoproliferative disorders (PTLD) is a serious complication after solid organ transplantation.
  • We report a prospective analysis of 30 patients with PTLD after heart or kidney transplantation.
  • Five patients were treated heterogeneously; in the remaining 20, the efficacy and safety of a weekly anthracycline-based chemotherapy were assessed.
  • One death was related to treatment.
  • With a median follow-up of 36 months, 3-year overall survival was 63.3% and 57% for the entire group and the chemotherapy-treated group, respectively.
  • In this study, we demonstrated that most PTLD need other treatment than RI and a weekly regimen is manageable and has a favourable impact on long-term survival.
  • [MeSH-major] Heart Transplantation / adverse effects. Kidney Transplantation / adverse effects. Lymphoproliferative Disorders / etiology
  • [MeSH-minor] Adolescent. Adult. Aged. Antineoplastic Combined Chemotherapy Protocols. Female. Hodgkin Disease / therapy. Humans. Immunosuppressive Agents / administration & dosage. Immunosuppressive Agents / adverse effects. Lymphoma, Non-Hodgkin / therapy. Male. Middle Aged. Neoplasms, Second Primary / etiology. Prospective Studies. Survival Rate

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  • [Copyright] Copyright 2008 S. Karger AG, Basel.
  • (PMID = 18797163.001).
  • [ISSN] 1421-9662
  • [Journal-full-title] Acta haematologica
  • [ISO-abbreviation] Acta Haematol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Switzerland
  • [Chemical-registry-number] 0 / Immunosuppressive Agents
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25. Nehring AK, Dua U, Mollee P, Gill D, Grimmett K, Khanna R, Moss D, Gandhi MK: Epstein-Barr virus T-cell immunity despite rituximab. Br J Haematol; 2007 Feb;136(4):628-32
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • Immunosuppression following solid organ transplantation results in impaired T-cell immunity and risk of Epstein-Barr virus (EBV)-positive post-transplant lymphoproliferative disorders (PTLD).
  • The B-cell targeting antibody rituximab has efficacy in PTLD.
  • To avoid the confounding factor of concurrent immunosuppression to prevent transplant rejection, immunity was analysed in non-transplanted lymphoma patients (i.e. a non-PTLD setting).
  • [MeSH-major] Antibodies, Monoclonal / pharmacology. Antineoplastic Agents / pharmacology. CD8-Positive T-Lymphocytes / drug effects. Epstein-Barr Virus Infections / immunology. Lymphoma, Non-Hodgkin / drug therapy
  • [MeSH-minor] Aged. Antibodies, Monoclonal, Murine-Derived. Cells, Cultured. Female. Humans. Immunity, Cellular / drug effects. Male. Middle Aged. Rituximab. T-Lymphocytes, Cytotoxic / drug effects. T-Lymphocytes, Cytotoxic / immunology

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  • (PMID = 17223914.001).
  • [ISSN] 0007-1048
  • [Journal-full-title] British journal of haematology
  • [ISO-abbreviation] Br. J. Haematol.
  • [Language] eng
  • [Publication-type] Controlled Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antibodies, Monoclonal; 0 / Antibodies, Monoclonal, Murine-Derived; 0 / Antineoplastic Agents; 4F4X42SYQ6 / Rituximab
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26. Flanagan KH, Brennan DC: EBV-associated recurrent Hodgkin's disease after renal transplantation. Transpl Int; 2006 Apr;19(4):338-41
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] EBV-associated recurrent Hodgkin's disease after renal transplantation.
  • Hodgkin's disease is recognized as part of the spectrum of post-transplantation lymphoproliferative disorders (PTLD), although it is still an uncommon de novo malignancy in this population.
  • Epstein-Barr virus (EBV) has been linked to both post-transplant non-Hodgkin's lymphomas and Hodgkin's disease.
  • We report a case of recurrent Hodgkin's disease in a patient who received a renal transplant in childhood and later developed EBV-associated Hodgkin's disease with remission after chemotherapy until subsequent relapse 9 years later that was successfully treated.
  • To our knowledge, this is the first report of recurrent Hodgkin's disease in a transplant recipient.
  • We briefly discuss the pathogenesis of and risk factors for EBV-related PTLD, utility of EBV load surveillance, and the options for treatment of PTLD including immunosuppression reduction, antiviral therapy, anti-CD20 monoclonal antibodies, cytotoxic T cells, and the possible roles of interferon-alpha and rapamycin.
  • [MeSH-major] Epstein-Barr Virus Infections / etiology. Hodgkin Disease / etiology. Kidney Transplantation / adverse effects
  • [MeSH-minor] Adult. Herpesvirus 4, Human / isolation & purification. Humans. Kidney Failure, Chronic / surgery. Lymphoproliferative Disorders / etiology. Lymphoproliferative Disorders / therapy. Male. Recurrence. Risk Factors

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  • (PMID = 16573551.001).
  • [ISSN] 0934-0874
  • [Journal-full-title] Transplant international : official journal of the European Society for Organ Transplantation
  • [ISO-abbreviation] Transpl. Int.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Germany
  • [Other-IDs] NLM/ PMC1448701
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27. Jenkins D, DiFrancesco L, Chaudhry A, Morris D, Glück S, Jones A, Woodman R, Brown CB, Russell J, Stewart DA: Successful treatment of post-transplant lymphoproliferative disorder in autologous blood stem cell transplant recipients. Bone Marrow Transplant; 2002 Sep;30(5):321-6
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  • [Title] Successful treatment of post-transplant lymphoproliferative disorder in autologous blood stem cell transplant recipients.
  • We report three cases of post-transplant lymphoproliferative disorder (PTLD) in the context of autologous stem cell transplantation (ASCT) for multiple myeloma (MM) and non-Hodgkin's lymphoma.
  • Both these cases of PTLD achieved a complete response following treatment with IVIG, gancyclovir, solumedrol and interferon (IFN).
  • The third case received ASCT with an unmanipulated autograft for relapsed angioimmunoblastic lymphoma.
  • None of these patients experienced a relapse of their PTLD with follow-up ranging from 1.5 to 5 years.
  • These cases highlight the importance of considering PTLD in the differential diagnosis of lymphadenopathy and fever post ASCT.
  • They also demonstrate the possibility of durable complete remission of post-ASCT PTLD following antiviral and immune modulating therapy.
  • [MeSH-major] Lymphoproliferative Disorders / drug therapy. Peripheral Blood Stem Cell Transplantation / adverse effects
  • [MeSH-minor] Adult. Antineoplastic Agents / administration & dosage. Antiviral Agents / administration & dosage. Diagnosis, Differential. Humans. Immunoblastic Lymphadenopathy / complications. Immunoblastic Lymphadenopathy / therapy. Immunotherapy. Lymphoma, Non-Hodgkin / complications. Lymphoma, Non-Hodgkin / therapy. Male. Middle Aged. Multiple Myeloma / complications. Multiple Myeloma / therapy. Remission Induction / methods. Transplantation, Autologous / adverse effects

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  • (PMID = 12209355.001).
  • [ISSN] 0268-3369
  • [Journal-full-title] Bone marrow transplantation
  • [ISO-abbreviation] Bone Marrow Transplant.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Antiviral Agents
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28. Lei KI, Chan LY, Chan WY, Johnson PJ, Lo YM: Quantitative analysis of circulating cell-free Epstein-Barr virus (EBV) DNA levels in patients with EBV-associated lymphoid malignancies. Br J Haematol; 2000 Oct;111(1):239-46
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  • Cell-free Epstein-Barr virus (EBV) DNA has recently been detected in the plasma and serum of patients with Hodgkin's disease, post-transplant lymphoproliferative disease (PTLD) and acquired immunodeficiency syndrome-related lymphoma.
  • However, no data are available on the temporal variation of plasma/serum EBV DNA levels in patients with EBV-associated lymphoid malignancies during the course of therapy.
  • Using a real-time quantitative polymerase chain reaction assay, we studied the plasma EBV DNA levels in 13 patients with EBV-associated lymphoid malignancies (six patients with Hodgkin's disease, four with nasal natural killer/T-cell lymphoma, two cases of PTLD and one patient with Burkitt's lymphoma) at presentation and during therapy.
  • The one patient who had no detectable plasma EBV DNA was also negative for EBERs in tumour tissue.
  • Serial measurements of plasma EBV DNA levels were performed in nine of the patients during the course of therapy.
  • All patients who responded to therapy demonstrated a significant reduction of plasma EBV DNA to low or undetectable levels, whereas in two patients with ineffective therapy, disease progression was associated with a rapid increase in plasma EBV DNA levels.
  • As plasma EBV DNA levels correlate well with the therapeutic response, such analysis may be a valuable tool for monitoring clinical progress.
  • [MeSH-major] DNA, Viral / blood. Herpesvirus 4, Human / genetics. Hodgkin Disease / virology
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Antiviral Agents / therapeutic use. Case-Control Studies. Disease Progression. Female. Follow-Up Studies. Humans. In Situ Hybridization. Lymphoma, AIDS-Related / drug therapy. Lymphoma, AIDS-Related / virology. Lymphoma, T-Cell / drug therapy. Lymphoma, T-Cell / virology. Lymphoproliferative Disorders / drug therapy. Lymphoproliferative Disorders / virology. Male. Middle Aged. Polymerase Chain Reaction / methods. Statistics, Nonparametric

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  • (PMID = 11091207.001).
  • [ISSN] 0007-1048
  • [Journal-full-title] British journal of haematology
  • [ISO-abbreviation] Br. J. Haematol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] ENGLAND
  • [Chemical-registry-number] 0 / Antiviral Agents; 0 / DNA, Viral
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29. Rossi D, Ramponi A, Franceschetti S, Stratta P, Gaidano G: Bone marrow necrosis complicating post-transplant lymphoproliferative disorder: resolution with rituximab. Leuk Res; 2008 May;32(5):829-34
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  • [Title] Bone marrow necrosis complicating post-transplant lymphoproliferative disorder: resolution with rituximab.
  • Among malignancies, non-Hodgkin lymphoma (NHL) accounts for 10% of cases of bone marrow necrosis.
  • Virtually all reported cases of NHL-associated bone marrow necrosis have developed in immunocompetent hosts.
  • We report on a case of bone marrow necrosis complicating post-transplant lymphoproliferative disorder (PTLD) and resolving after rituximab monotherapy.
  • This case report provides the first evidence of (i) bone marrow necrosis as a complication of PTLD;.
  • (ii) rapid resolution of NHL-associated bone marrow necrosis after rituximab treatment.
  • [MeSH-major] Antibodies, Monoclonal / therapeutic use. Bone Marrow / pathology. Kidney Transplantation / adverse effects. Lymphoproliferative Disorders / drug therapy
  • [MeSH-minor] Aged. Antibodies, Monoclonal, Murine-Derived. Fluorodeoxyglucose F18. Humans. Male. Necrosis. Positron-Emission Tomography. Rituximab. Tomography, X-Ray Computed

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  • (PMID = 18036657.001).
  • [ISSN] 0145-2126
  • [Journal-full-title] Leukemia research
  • [ISO-abbreviation] Leuk. Res.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antibodies, Monoclonal; 0 / Antibodies, Monoclonal, Murine-Derived; 0Z5B2CJX4D / Fluorodeoxyglucose F18; 4F4X42SYQ6 / Rituximab
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30. Novoa-Takara L, Dincer A, Kampalath B, Van Tuinen P, Hariharan S, Chang C: Post-transplant lymphoproliferative disorder with Hodgkin's lymphoma and large B-cell lymphoma differentiation. Histopathology; 2005 Sep;47(3):333-4
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Post-transplant lymphoproliferative disorder with Hodgkin's lymphoma and large B-cell lymphoma differentiation.
  • [MeSH-major] Hodgkin Disease / pathology. Kidney Transplantation. Lymphoma, B-Cell / pathology. Lymphoma, Large B-Cell, Diffuse / pathology. Lymphoproliferative Disorders / pathology
  • [MeSH-minor] Adult. Antibodies, Monoclonal / therapeutic use. Antibodies, Monoclonal, Murine-Derived. Antigens, CD / analysis. Antigens, CD15 / analysis. Antigens, CD20 / analysis. Antigens, CD30 / analysis. Antigens, CD45 / analysis. Antigens, CD79. Antigens, CD95 / analysis. Antineoplastic Agents / therapeutic use. Cell Differentiation. Chromosome Deletion. Chromosomes, Human, Pair 6 / genetics. Epstein-Barr Virus Infections / pathology. Humans. Immunohistochemistry. Male. Postoperative Complications / drug therapy. Postoperative Complications / pathology. Receptors, Antigen, B-Cell / analysis. Rituximab. Treatment Outcome

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  • [CommentIn] Histopathology. 2007 Feb;50(3):403-4 [17257146.001]
  • (PMID = 16115242.001).
  • [ISSN] 0309-0167
  • [Journal-full-title] Histopathology
  • [ISO-abbreviation] Histopathology
  • [Language] eng
  • [Publication-type] Case Reports; Letter
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antibodies, Monoclonal; 0 / Antibodies, Monoclonal, Murine-Derived; 0 / Antigens, CD; 0 / Antigens, CD15; 0 / Antigens, CD20; 0 / Antigens, CD30; 0 / Antigens, CD79; 0 / Antigens, CD95; 0 / Antineoplastic Agents; 0 / CD79A protein, human; 0 / Receptors, Antigen, B-Cell; 4F4X42SYQ6 / Rituximab; EC 3.1.3.48 / Antigens, CD45
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