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1. 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-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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2. Choi JH, Park BB, Suh C, Won JH, Lee WS, Shin HJ: Clinical characteristics of monomorphic post-transplant lymphoproliferative disorders. J Korean Med Sci; 2010 Apr;25(4):523-6
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  • [Title] Clinical characteristics of monomorphic post-transplant lymphoproliferative disorders.
  • Post-transplant lymphoproliferative disorders (PTLD) are a heterogeneous group of lymphoproliferative disorders associated with immunosuppression and Epstein-Barr virus infection.
  • PTLD is classified into three major categories: early lesions, polymorphic PTLD, and monomorphic PTLD.
  • The majority of monomorphic PTLD cases are non-Hodgkin's lymphoma of B-cell origin.
  • This retrospective study was conducted to investigate the incidence, clinical manifestation, treatment, and outcomes of monomorphic PTLD among 5,817 recipients of solid organ or allogeneic hematopoietic stem cell transplantation from five institutions.
  • Fourteen patients with monomorphic PTLD were identified (male:female 11:3; median age 42.6 yr, range 24-60).
  • The most common disease type was diffuse large B cell lymphoma (n=7).
  • The median time between the transplant and diagnosis of PTLD was 85.8 months.
  • However, all cases of PTLD after allogeneic hematopoietic stem cell transplantation occurred within 1 yr after transplantation.
  • Fourteen patients received combination systemic chemotherapy and four patients were treated with radiation therapy.
  • The present study indicates a lower incidence rate and a longer median time before the development of PTLD than those of previous reports.
  • Careful monitoring was needed after allogeneic hematopoietic stem cell transplantation for PTLD.
  • [MeSH-major] Lymphoproliferative Disorders / physiopathology. Transplantation, Homologous / adverse effects
  • [MeSH-minor] Adult. Epstein-Barr Virus Infections / complications. Epstein-Barr Virus Infections / immunology. Female. Herpesvirus 4, Human. Humans. Male. Middle Aged. Retrospective Studies. Survival Rate. Treatment Outcome. Young Adult

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  • (PMID = 20357991.001).
  • [ISSN] 1598-6357
  • [Journal-full-title] Journal of Korean medical science
  • [ISO-abbreviation] J. Korean Med. Sci.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Korea (South)
  • [Other-IDs] NLM/ PMC2844611
  • [Keywords] NOTNLM ; Monomorphic Post-transplant Lymphoproliferative Disorders
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3. Gonzalez-Cuyar LF, Tavora F, Burke AP, Gocke CD, Zimrin A, Sauk JJ, Zhao XF: Monomorphic post-transplant lymphoproliferative disorder of the tongue: case report and review of literature. Diagn Pathol; 2007;2:49

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  • [Title] Monomorphic post-transplant lymphoproliferative disorder of the tongue: case report and review of literature.
  • BACKGROUND: Post-transplant lymphoproliferative disorder (PTLD) is a spectrum of hematological diseases arising in context of immunosuppression after organ transplantation.
  • PTLD can involve any organ; however, it is extremely rare in oral cavity.
  • METHODS: Using morphologic and immunophenotypic approaches we have studied a case of monomorphic PTLD of the tongue that developed in a patient following unilateral kidney and pancreas transplantation on immunosuppressive therapy.
  • Additionally, cases of PTLD in the oral cavity were reviewed in the English literature.
  • RESULTS: The neoplasm showed large cell morphology and B-cell phenotype.
  • Complete remission was obtained after decreasing immunosuppressive therapy.
  • CONCLUSION: This rare case increased our awareness of PTLD in the oral cavity of patients following solid organ transplantation and immunosuppressive therapy.

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  • (PMID = 18093326.001).
  • [ISSN] 1746-1596
  • [Journal-full-title] Diagnostic pathology
  • [ISO-abbreviation] Diagn Pathol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Other-IDs] NLM/ PMC2231341
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4. Ryu HJ, Hahn JS, Kim YS, Park K, Yang WI, Lee JD: Complete resolution of posttransplant lymphoproliferative disorder (diffuse large B-cell lymphoma) with reduction of immunosuppressive therapy. Yonsei Med J; 2004 Jun 30;45(3):527-32
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  • [Title] Complete resolution of posttransplant lymphoproliferative disorder (diffuse large B-cell lymphoma) with reduction of immunosuppressive therapy.
  • Posttransplant lymphoproliferative disorder (PTLD) is a serious complication of organ transplantation.
  • PTLD is the disorder arising from the combined effects of Epstein-Barr virus associated lymphoid proliferation with the disruption of the normal immune control by the cytotoxic T cells.
  • The treatment for PTLD is one of the most controversial topics in solid organ transplantation.
  • It is well known that the initial management of PTLD is a reduction of immunosuppression.
  • Early diagnosis and the early reduction in immunosuppression are essential even for monomorphic lymphoma.
  • We report here on a case of the complete resolution of PTLD (diffuse large B cell lymphoma) which occurred after a drastic reduction of immunosuppression in a renal transplant recipient.
  • [MeSH-major] Graft Rejection / drug therapy. Immunosuppressive Agents / administration & dosage. Kidney Transplantation. Lymphoma, Large B-Cell, Diffuse / drug therapy
  • [MeSH-minor] Adult. Humans. Korea. Male. Remission Induction. Tomography, Emission-Computed. Tomography, X-Ray Computed

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  • (PMID = 15227742.001).
  • [ISSN] 0513-5796
  • [Journal-full-title] Yonsei medical journal
  • [ISO-abbreviation] Yonsei Med. J.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Korea (South)
  • [Chemical-registry-number] 0 / Immunosuppressive Agents
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5. Cavaliere R, Petroni G, Lopes MB, Schiff D, International Primary Central Nervous System Lymphoma Collaborative Group: Primary central nervous system post-transplantation lymphoproliferative disorder: an International Primary Central Nervous System Lymphoma Collaborative Group Report. Cancer; 2010 Feb 15;116(4):863-70
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  • [Title] Primary central nervous system post-transplantation lymphoproliferative disorder: an International Primary Central Nervous System Lymphoma Collaborative Group Report.
  • BACKGROUND: Primary central nervous system (CNS) post-transplantation lymphoproliferative disorder (PCNS-PTLD) is a rare complication of solid organ transplantation.
  • The objectives of this study were to define the clinical, radiologic, and pathologic features of this disease and to explore the impact of treatment on patient outcomes.
  • METHODS: The authors reviewed the databases of participating institutions of the International Primary CNS Lymphoma Collaborative Group for cases of PCNS-PTLD.
  • Thirty-four patients who had pathologically confirmed PCNS-PTLD without evidence of systemic PTLD were investigated retrospectively.
  • RESULTS: The median time from transplantation to diagnosis of PCNS-PTLD was 4.4 years.
  • Most patients had monomorphic, Epstein-Barr virus (EBV)-positive disease of B-cell origin.
  • Response rates were high regardless of treatment type, and the median survival was 47 months.
  • CONCLUSIONS: The current study demonstrated that PCNS-PTLD is typically an EBV-induced B-cell lymphoma that is responsive to treatment with favorable survival in many patients.
  • An aggressive approach to tissue confirmation of diagnosis and treatment with chemotherapy or radiotherapy should be strongly considered.
  • [MeSH-major] Central Nervous System Diseases / epidemiology. Immunosuppressive Agents / adverse effects. Lymphoproliferative Disorders / diagnosis. Lymphoproliferative Disorders / epidemiology. Organ Transplantation / adverse effects
  • [MeSH-minor] Adolescent. Adult. Age Factors. Child. Child, Preschool. Combined Modality Therapy. Female. Humans. Male. Middle Aged. Postoperative Complications. Time Factors

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  • (PMID = 20052713.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / R13 CA124293
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Immunosuppressive Agents
  • [Other-IDs] NLM/ NIHMS585616; NLM/ PMC4113953
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6. 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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7. 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.
  • 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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8. Godt C, Regnery A, Schwarze B, Junker K, Porschen R: A rare cause of ulcerative colitis - diarrhoea and perianal bleeding due to posttransplant lymphoproliferative disorder (PTLD). Z Gastroenterol; 2009 Mar;47(3):283-7
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  • [Title] A rare cause of ulcerative colitis - diarrhoea and perianal bleeding due to posttransplant lymphoproliferative disorder (PTLD).
  • Post-transplant lymphoproliferative disorder (PTLD) is characterised by frequent extranodal manifestation, in 20 - 25 % including the gastrointestinal tract.
  • He had received a bone marrow transplant two years previously for an acute lymphocytic leukaemia of B-cell origin.
  • Histologically, a monomorphic post-transplant lymphoproliferative disorder was diagnosed, the subtype was a high grade diffuse-large cell Non-Hodgkin's lymphoma of B-cell origin.
  • This is a common feature of PTLD and possibly plays a critical role in its pathogenesis.
  • The current therapeutic approach to the subtype of PTLD we saw in this patient is CHOP chemotherapy, comprising the anti-CD 20 antibody rituximab if CD 20-positivity is present.
  • This patient had a fatal course of the disease and died a few days after the first chemotherapy cycle due to severe multiple organ failure.
  • [MeSH-major] Antineoplastic Agents / adverse effects. Antineoplastic Agents / therapeutic use. Colitis, Ulcerative / etiology. Colorectal Neoplasms / diagnosis. Diarrhea / etiology. Gastrointestinal Hemorrhage / etiology. Hematopoietic Stem Cell Transplantation. Lymphoma, Large B-Cell, Diffuse / diagnosis. Precursor B-Cell Lymphoblastic Leukemia-Lymphoma / drug therapy


9. Mihara A, Chen CK, Yokoyama K, Ueda T, Tsukada Y, Awaya N, Mori T, Ikeda Y, Okamoto S: [Successful treatment with L-asparaginase-based combination chemotherapy for refractory T-cell post-transplant lymphoproliferative disorder]. Rinsho Ketsueki; 2007 Apr;48(4):305-9
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  • [Title] [Successful treatment with L-asparaginase-based combination chemotherapy for refractory T-cell post-transplant lymphoproliferative disorder].
  • A biopsy of the left tonsil showed a monotonous proliferation of atypical lymphocytes suggesting post-transplant lymphoproliferative disorder (PTLD).
  • The reduction of immunosuppressants did not result in any clinical improvements, and he developed bilateral cervical lymphadenopathy.
  • T-cell receptor rearrangement, but not EBER, was detected.
  • Based on these findings, monomorphic T-cell PTLD was diagnosed.
  • He was treated with four different chemotherapeutic regimens without any clinical improvements, and the PTLD became leukemic.
  • Chemotherapy consisting of L-asparaginase, vincristine, and dexamethasone (LVD) was then given, which resulted in massive tumor lysis.
  • T-cell PTLD is a rare disorder, characterized by its refractoriness to chemotherapy as opposed to B-cell PTLD.
  • Our experience suggests that L-asparaginase-based chemotherapy may improve the prognosis of T-cell PTLD.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Asparaginase / administration & dosage. Kidney Transplantation / adverse effects. Lymphoproliferative Disorders / drug therapy. T-Lymphocytes / pathology

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  • (PMID = 17515121.001).
  • [ISSN] 0485-1439
  • [Journal-full-title] [Rinshō ketsueki] The Japanese journal of clinical hematology
  • [ISO-abbreviation] Rinsho Ketsueki
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 5J49Q6B70F / Vincristine; 7S5I7G3JQL / Dexamethasone; EC 3.5.1.1 / Asparaginase
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10. Mamzer-Bruneel MF, Lomé C, Morelon E, Levy V, Bourquelot P, Jacobs F, Gessain A, Mac Intyre E, Brousse N, Kreis H, Hermine O: Durable remission after aggressive chemotherapy for very late post-kidney transplant lymphoproliferation: A report of 16 cases observed in a single center. J Clin Oncol; 2000 Nov 01;18(21):3622-32
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  • [Title] Durable remission after aggressive chemotherapy for very late post-kidney transplant lymphoproliferation: A report of 16 cases observed in a single center.
  • PURPOSE: Posttransplant lymphoproliferative diseases (PTLDs) represent a group of potentially lethal lymphoid proliferations that may complicate the course of solid organ transplantation.
  • We particularly emphasized the follow-up of patients treated with conventional chemotherapy.
  • PATIENTS AND METHODS: The medical histories of all patients who developed very late-onset PTLD in our institution were reviewed, and diagnostic biopsy materials were retrospectively studied.
  • Mean (+/- SD) time to tumor onset was 103.93 +/- 70.88 months.
  • Most tumors were Epstein-Barr virus-related monomorphic large-cell PTLDs of B phenotype.
  • Ten patients received conventional chemotherapy (cyclophosphamide, doxorubicin, vincristine, and prednisone regimen).
  • Two of them died within 2 months, two achieved partial remission, and six achieved definitive complete remission.
  • Overall median survival time was 13 months and rose to 27 months in the treated group.
  • None of the treated patients experienced rejection despite withdrawal of immunosuppressive treatment.
  • CONCLUSION: Despite characteristics of aggressive lymphoma, very late-onset PTLDs after renal transplantation may respond to conventional chemotherapy.
  • However, because a high rate of infectious complications occurred, new therapeutic strategies, such as combinations of anti-CD20 monoclonal antibodies and lower doses of chemotherapy, are warranted.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Kidney Transplantation. Lymphoproliferative Disorders / drug therapy. Postoperative Complications / drug therapy
  • [MeSH-minor] Adult. Antibodies, Viral / blood. Cyclophosphamide / administration & dosage. Doxorubicin / administration & dosage. Epstein-Barr Virus Infections / complications. Female. Graft Rejection. Herpesviridae Infections / blood. Herpesviridae Infections / immunology. Herpesvirus 4, Human. Herpesvirus 8, Human / immunology. Humans. Immunosuppressive Agents / therapeutic use. Incidence. Kidney / physiology. Kidney Diseases / surgery. Male. Middle Aged. Prednisone / administration & dosage. Remission Induction. Retrospective Studies. Survival Analysis. Time Factors. Treatment Outcome. Vincristine / administration & dosage

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  • (PMID = 11054435.001).
  • [ISSN] 0732-183X
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antibodies, Viral; 0 / Immunosuppressive Agents; 5J49Q6B70F / Vincristine; 80168379AG / Doxorubicin; 8N3DW7272P / Cyclophosphamide; VB0R961HZT / Prednisone; CHOP protocol
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11. Jain M, Badwal S, Pandey R, Srivastava A, Sharma RK, Gupta RK: Post-transplant lymphoproliferative disorders after live donor renal transplantation. Clin Transplant; 2005 Oct;19(5):668-73
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  • [Title] Post-transplant lymphoproliferative disorders after live donor renal transplantation.
  • The development of post-transplant lymphoproliferative disorders (PTLD) is a well-recognized complication of solid organ transplantation in patients receiving immunosuppressive therapy.
  • The literature on PTLD in live renal allograft recipients is scarce and most of the data pertains to PTLD in cadaveric transplants.
  • As live donor grafts form the mainstay of transplantation programme in India, this study was carried out to define the profile of PTLD in live donor renal allograft recipients.
  • On retrospective evaluation, nine cases of PTLD amongst 1700 live donor allograft recipients from January 1989 to August 2004, were detected at a tertiary care hospital in north India.
  • Mean age at diagnosis of PTLD was 38 yr with median post-transplant latency period of 7 yr.
  • All cases received cyclosporin, azathioprine and prednisolone in varying combinations as immunosuppressive therapy.
  • Seven patients were seronegative for Epstein-Barr virus at the time of diagnosis.
  • All were B-cell monomorphic PTLD, classifiable as B-cell diffuse large cell lymphomas, with five extranodal and three nodal lymphomas.
  • Management included reduction in immunosuppression, acyclovir therapy, surgical excision and chemotherapy.
  • This study comprising of live related/unrelated renal allograft recipients observed late onset high grade monomorphic PTLD with paucity of early onset polymorphic lesions.
  • Long post-transplant latency period, aggressive behaviour and poor response to treatment necessitate long-term cancer surveillance to facilitate early detection and newer therapeutic strategies to improve the outcome in these patients.
  • [MeSH-major] Kidney Transplantation. Living Donors. Lymphoproliferative Disorders / etiology
  • [MeSH-minor] Adult. Biopsy. Female. Follow-Up Studies. Graft Rejection / complications. Graft Rejection / prevention & control. Humans. Immunosuppressive Agents / adverse effects. Immunosuppressive Agents / therapeutic use. Incidence. India / epidemiology. Male. Middle Aged. Retrospective Studies. Risk Factors. Transplantation, Homologous

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  • (PMID = 16146560.001).
  • [ISSN] 0902-0063
  • [Journal-full-title] Clinical transplantation
  • [ISO-abbreviation] Clin Transplant
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] Denmark
  • [Chemical-registry-number] 0 / Immunosuppressive Agents
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12. Serinet MO, Jacquemin E, Habes D, Debray D, Fabre M, Bernard O: Anti-CD20 monoclonal antibody (Rituximab) treatment for Epstein-Barr virus-associated, B-cell lymphoproliferative disease in pediatric liver transplant recipients. J Pediatr Gastroenterol Nutr; 2002 Apr;34(4):389-93
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  • [Title] Anti-CD20 monoclonal antibody (Rituximab) treatment for Epstein-Barr virus-associated, B-cell lymphoproliferative disease in pediatric liver transplant recipients.
  • OBJECTIVES: Anti-B-cell immunotherapy has been used with success in adults with posttransplant B-cell lymphoproliferative disease (PTLD), but such treatment has rarely been reported in children.
  • We report the outcome of anti-CD20 antibody (rituximab) therapy for Epstein-Barr virus (EBV)-associated PTLD in six pediatric liver transplant recipients.
  • METHODS: In these six patients, PTLD was diagnosed within 2 to 4 months after transplantation.
  • The tumors were classified as monomorphic or polymorphic B-cell infiltrate expressing CD20 antigen and EBV genome.
  • Anti-CD20 therapy was associated with withdrawal of tacrolimus or ciclosporine therapy in all patients.
  • RESULTS: Rituximab treatment was associated with decreased EBV load, disappearance of abnormal serum immunoglobulin concentration, and disappearance of tumoral masses, which occurred 1 to 2.5 months after treatment onset.
  • Despite rituximab therapy, one patient was diagnosed subsequently with a cerebral tumor.
  • Five patients experienced acute liver graft rejection episodes within 10 days to 2.5 months after beginning treatment.
  • Three children are alive and in complete remission, with normal liver tests, 15 months to 3 years after PTLD onset.
  • CONCLUSIONS: Rituximab therapy is an interesting approach for children with early EBV-associated PTLD after liver transplantation.
  • [MeSH-major] Antibodies, Monoclonal / therapeutic use. Antineoplastic Agents / therapeutic use. B-Lymphocytes / immunology. Epstein-Barr Virus Infections / complications. Liver Transplantation / adverse effects. Lymphoproliferative Disorders / drug therapy

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  • [CommentIn] J Pediatr Gastroenterol Nutr. 2002 Apr;34(4):359-61 [11930089.001]
  • (PMID = 11930095.001).
  • [ISSN] 0277-2116
  • [Journal-full-title] Journal of pediatric gastroenterology and nutrition
  • [ISO-abbreviation] J. Pediatr. Gastroenterol. Nutr.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antibodies, Monoclonal; 0 / Antibodies, Monoclonal, Murine-Derived; 0 / Antineoplastic Agents; 4F4X42SYQ6 / Rituximab
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13. Wang E, Stoecker M: Primary cutaneous giant cell plasmacytoma in an organ transplant recipient: a rare presentation of a posttransplant lymphoproliferative disorder. Am J Dermatopathol; 2010 Jul;32(5):479-85
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  • [Title] Primary cutaneous giant cell plasmacytoma in an organ transplant recipient: a rare presentation of a posttransplant lymphoproliferative disorder.
  • Posttransplant lymphoproliferative disorder (PTLD) is comprised of a spectrum of lymphoid diseases, ranging from early lesions, such as plasmacytic hyperplasia, to monomorphic neoplasms, including plasmacytoma-like lesions.
  • Although PTLD may involve a variety of organs, primary cutaneous PTLD is rare.
  • We report a unique case of Epstein-Barr virus (EBV)-positive primary cutaneous giant cell plasmacytoma developed 5 years after renal/pancreatic transplant in a 55-year-old male patient.
  • A review of the literature identified additional 49 cases of primary cutaneous B-cell PTLD, including 18 cases of plasmacytoma-like lesions.
  • Primary cutaneous B-cell PTLD usually presents years after transplantation, has male preponderance, tends to occur on extremities, is frequently EBV-associated, and predicts a favorable clinical outcome.
  • Unlike PTLD in general, in which EBV-positive cases usually occur earlier than EBV-negative ones, the longer presentation interval in the cutaneous PTLD seems to be uncorrelated to EBV status.
  • Compared with other subtypes of cutaneous B-cell PTLD, plasmacytoma-like lesions have an increased male preponderance and tendency to present on the extremities.
  • Although the majority of cases have been treated with reduction of immunosuppression, antiviral therapy and/or local radiotherapy, and a few with chemotherapy, the best therapeutic intervention for primary cutaneous B-cell PTLD remains to be further investigated with the analysis of more reported cases and large clinical trials.
  • [MeSH-major] Carcinoma, Giant Cell / pathology. Kidney Transplantation. Pancreas Transplantation. Plasmacytoma / pathology. Skin Neoplasms / pathology

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  • (PMID = 20414094.001).
  • [ISSN] 1533-0311
  • [Journal-full-title] The American Journal of dermatopathology
  • [ISO-abbreviation] Am J Dermatopathol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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14. Allen U, Hébert D, Moore D, Dror Y, Wasfy S, Canadian PTLD Survey Group--1998: Epstein-Barr virus-related post-transplant lymphoproliferative disease in solid organ transplant recipients, 1988-97: a Canadian multi-centre experience. Pediatr Transplant; 2001 Jun;5(3):198-203
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Epstein-Barr virus-related post-transplant lymphoproliferative disease in solid organ transplant recipients, 1988-97: a Canadian multi-centre experience.
  • The aim of this work was to obtain information on the magnitude of the problem, disease characteristics, and clinical practices relating to post-transplant lymphoproliferative disease (PTLD) in Canadian institutions.
  • Adult and pediatric Canadian solid organ transplant groups were sent a questionnaire between July and October 1998.
  • Analyzable data were obtained from 33 transplant groups.
  • For the period 1988-97, 90 cases of PTLD were seen among 4283 solid organ transplant recipients.
  • The incidence of PTLD varied from 0 to 14.6%, with the highest rates in children.
  • The lesions were of B-cell origin in 42.2% and of T-cell in 15.6%.
  • The lesions were classified as monomorphic in 31.1%, polymorphic 18.9%, and hyperplastic in 1.1%.
  • Chemotherapy was used in 27.8%, while immune globulin was used in 22.2%.
  • Surgical resection was used in 20.0%, radiotherapy in 14.4%, and interferon-alpha therapy in 12.2%.
  • In conclusion, the incidence of PTLD varies widely across Canadian centres.
  • [MeSH-major] Epstein-Barr Virus Infections / complications. Epstein-Barr Virus Infections / epidemiology. Lymphoproliferative Disorders / complications. Lymphoproliferative Disorders / epidemiology. Organ Transplantation / statistics & numerical data. Postoperative Complications / epidemiology
  • [MeSH-minor] Adolescent. Adult. Canada / epidemiology. Child. Child, Preschool. Data Collection. Humans. Incidence. Time Factors

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  • (PMID = 11422823.001).
  • [ISSN] 1397-3142
  • [Journal-full-title] Pediatric transplantation
  • [ISO-abbreviation] Pediatr Transplant
  • [Language] eng
  • [Publication-type] Journal Article; Multicenter Study
  • [Publication-country] Denmark
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15. Su IC, Lien HC, Chen CM: Primary brain T-cell lymphoma after kidney transplantation: a case report. Surg Neurol; 2006;66 Suppl 2:S60-3
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  • [Title] Primary brain T-cell lymphoma after kidney transplantation: a case report.
  • BACKGROUND: Development of primary brain PTLD after kidney transplantation is uncommon, and the incidence of T-cell phenotypes is much more rarely reported in the previous literature.
  • However, prognosis of T-cell PTLD is typically grave, so early diagnosis and treatment are crucial to patient survival.
  • CASE DESCRIPTION: A 60-year-old woman, who had received a kidney transplant 4 years previously, presented with focal seizures and left hemiparesis.
  • The tumor was grossly removed and its pathology was determined to be monomorphic T-cell lymphoma.
  • The patient underwent chemotherapy with a combination of carmustine, oncovin, and methylprednisolone.
  • The patient's neurologic signs, however, deteriorated rapidly, and the patient finally died of neutropenia and septic shock 1 month after chemotherapy.
  • CONCLUSIONS: Development of primary brain T-cell PTLD after kidney transplantation is rare and typically has a grave prognosis, emphasizing the importance of early diagnosis and treatment.
  • [MeSH-major] Brain Neoplasms / etiology. Kidney Transplantation / adverse effects. Lymphoma, T-Cell / etiology

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  • (PMID = 17071259.001).
  • [ISSN] 0090-3019
  • [Journal-full-title] Surgical neurology
  • [ISO-abbreviation] Surg Neurol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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16. 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
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17. Johnson J, Kerecuk L, Harrison M, Taylor JO, Odell E: Epstein-Barr virus-associated lymphoproliferative disease in oral cavity in a renal transplant recipient: a case report. Pediatr Transplant; 2007 May;11(3):340-4
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Epstein-Barr virus-associated lymphoproliferative disease in oral cavity in a renal transplant recipient: a case report.
  • A 10-yr-old child on long-term cyclosporin immunosuppression for a renal transplant presented with gingival swelling enlargement, in a background of gingival hyperplasia.
  • It is tempting to assume that it is a drug-related lesion; perhaps, an area of plaque-related inflammation.
  • An incisional biopsy revealed a monomorphic B-cell post-transplant lymphoproliferative disease (PTLD).
  • At this stage, high Epstein-Barrr virus (EBV) titres supported a diagnosis of EBV-driven PTLD.
  • The patient underwent six courses of cyclophosphamide, vincristine and prednisolone chemotherapy.
  • Her renal transplant still has good function and there is no evidence of PTLD recurrence 23 months after initial diagnosis.
  • This case illustrates that PTLD can manifest in unusual sites and in transplant recipients on cyclosporin immunosuppression it is easy to assume that any gingival hyperplasia is drug induced; however, the differential diagnosis of gingival hyperplasia should include PTLD.
  • [MeSH-major] Epstein-Barr Virus Infections / diagnosis. Gingival Diseases / pathology. Gingival Diseases / virology. Immunocompromised Host. Kidney Transplantation. Lymphoproliferative Disorders / diagnosis
  • [MeSH-minor] Antineoplastic Agents / therapeutic use. Biopsy. Child. Cyclophosphamide / therapeutic use. Diagnosis, Differential. Female. Humans. Hyperplasia / drug therapy. Immunosuppressive Agents / therapeutic use. Prednisolone / therapeutic use. Vincristine / therapeutic use

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  • (PMID = 17430495.001).
  • [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 / Antineoplastic Agents; 0 / Immunosuppressive Agents; 5J49Q6B70F / Vincristine; 8N3DW7272P / Cyclophosphamide; 9PHQ9Y1OLM / Prednisolone
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18. Kataoka K, Seo S, Sugawara Y, Ota S, Imai Y, Takahashi T, Fukayama M, Kokudo N, Kurokawa M: Post-transplant lymphoproliferative disorder after adult-to-adult living donor liver transplant: case series and review of literature. Leuk Lymphoma; 2010 Aug;51(8):1494-501
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  • [Title] Post-transplant lymphoproliferative disorder after adult-to-adult living donor liver transplant: case series and review of literature.
  • Post-transplant lymphoproliferative disorder (PTLD) is a serious complication of solid organ transplant.
  • Although living donor liver transplant (LDLT) has been increasingly performed, PTLD after LDLT has not been well investigated.
  • We aimed to determine the clinical characteristics of PTLD after LDLT.
  • We investigated 323 consecutive patients undergoing adult-to-adult LDLT and identified three patients who developed biopsy-proven PTLD.
  • All of them were seropositive for Epstein-Barr virus (EBV) and had hepatitis C virus-related cirrhosis at transplant.
  • All three patients developed late-onset and monomorphic PTLD, including one diffuse large B-cell lymphoma and two Burkitt lymphomas with c-myc rearrangement.
  • The initial therapy included chemotherapy, rituximab, and immunosuppression withdrawal.
  • One patient died of sepsis during treatment and two patients achieved complete responses.
  • We showed a relatively low incidence and distinct clinicopathological features of PTLD after adult-to-adult LDLT, which might reflect the unique nature of LDLT.
  • [MeSH-major] Liver Transplantation / adverse effects. Living Donors. Lymphoproliferative Disorders / etiology
  • [MeSH-minor] Adolescent. Adult. Aged. Epstein-Barr Virus Infections / diagnosis. Epstein-Barr Virus Infections / virology. Female. Herpesvirus 4, Human / isolation & purification. Humans. Male. Middle Aged. Positron-Emission Tomography. Retrospective Studies. Review Literature as Topic. Survival Rate. Treatment Outcome. Young Adult

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  • [CommentIn] Leuk Lymphoma. 2010 Aug;51(8):1393-4 [20497000.001]
  • (PMID = 20578817.001).
  • [ISSN] 1029-2403
  • [Journal-full-title] Leukemia & lymphoma
  • [ISO-abbreviation] Leuk. Lymphoma
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
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19. Ohta H, Fukushima N, Ozono K: Pediatric post-transplant lymphoproliferative disorder after cardiac transplantation. Int J Hematol; 2009 Sep;90(2):127-36
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  • [Title] Pediatric post-transplant lymphoproliferative disorder after cardiac transplantation.
  • Post-transplant lymphoproliferative disorder (PTLD) is a well recognized and potentially fatal complication after pediatric cardiac transplantation.
  • PTLD encompasses a wide spectrum, ranging from benign hyperplasia to more aggressive lymphoma.
  • Most cases are Epstein-Barr virus (EBV)-related B-cell tumors resulting from impaired immunity due to immunosuppressive therapy.
  • Pediatric recipients, often seronegative for EBV at transplantation, have a greater risk for PTLD than adults.
  • The clinical presentation of PTLD varies from isolated lymphadenopathy to systemic disease; common sites involved are gastrointestinal tract, lung or airway, and cervical lesions.
  • Timely and accurate diagnosis based on histological examination of biopsy tissue is essential for early intervention.
  • For prophylaxis when EBV viral loads are increasing or for initial treatment of early lesions or polymorphic PTLD, a reduction in immunosuppressive treatment is a key component of therapy, but caution is needed for possible rebound allograft rejection.
  • Chemotherapy is indicated for patients with poor response to reduced immunosuppression and for highly aggressive monomorphic PTLD.
  • The use of rituximab in combination with chemotherapy is effective.
  • For the time being, avoiding excessive immunosuppression is the most effective strategy for reducing the incidence of PTLD.
  • Calcineurin inhibitor (CNI) minimization with proliferation signal inhibitors (PSIs) or conversion from a CNI to a PSI might be useful for preventing both development of PTLD and allograft rejection.
  • [MeSH-major] Epstein-Barr Virus Infections / epidemiology. Heart Transplantation / statistics & numerical data. Immunocompromised Host. Lymphoproliferative Disorders / epidemiology. Postoperative Complications / epidemiology

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  • (PMID = 19669857.001).
  • [ISSN] 1865-3774
  • [Journal-full-title] International journal of hematology
  • [ISO-abbreviation] Int. J. Hematol.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Japan
  • [Number-of-references] 99
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20. 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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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [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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21. Reams BD, McAdams HP, Howell DN, Steele MP, Davis RD, Palmer SM: Posttransplant lymphoproliferative disorder: incidence, presentation, and response to treatment in lung transplant recipients. Chest; 2003 Oct;124(4):1242-9
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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 disorder: incidence, presentation, and response to treatment in lung transplant recipients.
  • INTRODUCTION: Posttransplant lymphoproliferative disorder (PTLD) is a relatively infrequent but devastating complication that occurs after solid-organ transplantation.
  • Although the optimal treatment for this condition is unknown, rituximab, a murine/human chimeric monoclonal antibody, has shown promise in the treatment of PTLD.
  • In this report, we define the incidence, clinical features at presentation, and response to treatment of all cases of PTLD observed at our institution over a 10-year period, including four patients who received treatment with rituximab.
  • METHODS: A review of all patients who underwent lung or heart-lung transplant at Duke University from 1992 to 2002 was performed (n = 400), and demographic and clinical outcome data were extracted.
  • RESULTS: PTLD was observed in 10 of 400 patients (2.5%).
  • Patients who acquired PTLD were predominantly > 55 years old (8 of 10 patients) and with a native disease of COPD (7 of 10 patients).
  • Diagnosis of PTLD was made a median of 343 days after transplant.
  • The type of transplant and Epstein-Barr virus (EBV) status prior to transplant did not appear to influence the risk for PTLD.
  • Histologic subtypes included polymorphic B cell (n = 4), monomorphic B cell (n = 3), B cell without further classification (n = 2), and anaplastic T cell (n = 1).
  • Patients treated with surgery or radiation (n = 2) or rituximab (n = 4) had favorable responses to therapy.
  • Both patients treated with chemotherapy died related to complications of treatment and PTLD.
  • CONCLUSIONS: Presentation and histologic appearance of PTLD varies considerably among lung transplant recipients.
  • PTLD was more frequent among older patients with COPD, regardless of pretransplant EBV serology.
  • Rituximab appears effective as a first-line therapy for PTLD, but additional studies are needed in order to define its efficacy and side effect profile in this population of patients.
  • [MeSH-major] Lung Transplantation / adverse effects. Lymphoproliferative Disorders / epidemiology. Lymphoproliferative Disorders / etiology

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  • (PMID = 14555552.001).
  • [ISSN] 0012-3692
  • [Journal-full-title] Chest
  • [ISO-abbreviation] Chest
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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22. Nelson BP, Nalesnik MA, Bahler DW, Locker J, Fung JJ, Swerdlow SH: Epstein-Barr virus-negative post-transplant lymphoproliferative disorders: a distinct entity? Am J Surg Pathol; 2000 Mar;24(3):375-85
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Epstein-Barr virus-negative post-transplant lymphoproliferative disorders: a distinct entity?
  • Post-transplant lymphoproliferative disorders (PTLDs) are usually but not invariably associated with Epstein-Barr virus (EBV).
  • Twenty-one percent of patients had at least one EBV-negative PTLD (14% of biopsies).
  • The initial EBV-negative PTLDs occurred a median of 50 months post-transplantation compared with 10 months for EBV-positive cases.
  • Of the EBV-negative PTLDs, 67% were of monomorphic type (M-PTLD) compared with 42% of EBV-positive cases (p <0.05).
  • The other EBV-negative PTLDs were of infectious mononucleosis-like, plasma cell-rich (n = 2), small B-cell lymphoid neoplasm, large granular lymphocyte disorder (n = 4) and polymorphic (P) types.
  • B-cell clonality was established in 14 specimens and T-cell clonality was established in three (two patients).
  • Rearrangement of c-MYC was identified in two M-PTLDs with small noncleaved-like features, and rearrangement of BCL-2 was found in one large noncleaved-like M-PTLD.
  • Ten patients were alive at 3 to 63 months (only three patients received chemotherapy).
  • Seven patients, all with M-PTLDs, are dead at 0.3 to 6 months.
  • Therefore, EBV-negative PTLDs have distinct features, but some do respond to decreased immunosuppression, similar to EBV-positive cases, suggesting that EBV positivity should not be an absolute criterion for the diagnosis of a PTLD.
  • [MeSH-major] Herpesvirus 4, Human / isolation & purification. Lymphoproliferative Disorders / pathology. Lymphoproliferative Disorders / virology. Organ Transplantation / adverse effects

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  • (PMID = 10716151.001).
  • [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
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23. Yedibela S, Reck T, Niedobitek G, Gramatzki M, Repp R, Hohenberger W, Ott R: Anti-CD20 monoclonal antibody treatment of Epstein-Barr virus-induced intrahepatic lymphoproliferative disorder following liver transplantation. Transpl Int; 2003 Mar;16(3):197-201
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  • [Title] Anti-CD20 monoclonal antibody treatment of Epstein-Barr virus-induced intrahepatic lymphoproliferative disorder following liver transplantation.
  • Epstein-Barr virus (EBV)-associated post-transplant lymphoproliferative disorders (PTLDs) are a common cause of death in transplant patients.
  • Despite various therapeutic approaches, there is still no consensus on a treatment strategy.
  • The treatment of transplant recipients with monoclonal antibodies directed against B-cell antigens is a new, therapeutic approach with which, however, little clinical experience has so far been gained.
  • Two patients developed intrahepatic PTLD 7 and 15 months, respectively, after transplantation.
  • In one case, this was diagnosed as polymorphic PTLD, in the other as monomorphic, monoclonal PTLD.
  • Treatment with rituximab was tolerated well by both patients.
  • Both patients died of secondary complications 10 weeks and 10 months, respectively, after the diagnosis of PTLD.
  • We can conclude that treatment of PTLD with Rituximab led to remission in both of our patients.
  • Nevertheless, progression of cholestasis persisted, and both patients ultimately died of complications unrelated to PTLD.
  • [MeSH-major] Antibodies, Monoclonal / therapeutic use. Antigens, CD20 / immunology. B-Lymphocytes / immunology. Epstein-Barr Virus Infections / immunology. Herpesvirus 4, Human / immunology. Liver Transplantation / adverse effects. Liver Transplantation / immunology. Lymphoproliferative Disorders / immunology
  • [MeSH-minor] Antibodies, Monoclonal, Murine-Derived. Antigens, CD / immunology. DNA Primers. Drug Therapy, Combination. Follow-Up Studies. Humans. Immunoglobulin Heavy Chains / genetics. Immunosuppressive Agents / therapeutic use. Polymerase Chain Reaction. Rituximab. Time Factors. Tomography, X-Ray Computed

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  • (PMID = 12664216.001).
  • [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] Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Antibodies, Monoclonal; 0 / Antibodies, Monoclonal, Murine-Derived; 0 / Antigens, CD; 0 / Antigens, CD20; 0 / DNA Primers; 0 / Immunoglobulin Heavy Chains; 0 / Immunosuppressive Agents; 4F4X42SYQ6 / Rituximab
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24. Cheng FW, Lee V, To KF, Chan KC, Shing MK, Li CK: Post-transplant EBV-related lymphoproliferative disorder complicating umbilical cord blood transplantation in patients of adrenoleukodystrophy. Pediatr Blood Cancer; 2009 Dec 15;53(7):1329-31
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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 EBV-related lymphoproliferative disorder complicating umbilical cord blood transplantation in patients of adrenoleukodystrophy.
  • EBV-associated post-transplant lymphoproliferative disorder (PTLD) is a well-recognized complication following solid organ transplantation and hematopoietic stem cell transplantation (HSCT) using bone marrow or peripheral blood as stem cell sources, but rarely reported in umbilical cord blood transplantation (UCBT).
  • We report two cases in unrelated UCBT setting and added the following new information to the literature: (i) EBV-related PTLD can be presented late in recipients of unrelated UCBT;.
  • (ii) in contrast to reported literatures that PTLD is a serious complication with unfavorable outcome, especially in monomorphic form, our cases showed that the clinical course may be relatively benign if treatment is initiated promptly.
  • [MeSH-major] Adrenoleukodystrophy / surgery. Cord Blood Stem Cell Transplantation. Epstein-Barr Virus Infections / complications. Lymphoproliferative Disorders / etiology. Postoperative Complications / etiology. Tumor Virus Infections / complications
  • [MeSH-minor] Acyclovir / therapeutic use. Antibodies, Monoclonal / therapeutic use. Antibodies, Monoclonal, Murine-Derived. Antiviral Agents / therapeutic use. Child. Child, Preschool. Combined Modality Therapy. Cyclosporine / adverse effects. Cyclosporine / therapeutic use. Graft vs Host Disease / drug therapy. Herpesvirus 4, Human / physiology. Humans. Immunoglobulins, Intravenous / therapeutic use. Immunologic Factors / therapeutic use. Immunosuppressive Agents / adverse effects. Immunosuppressive Agents / therapeutic use. Male. Prednisolone / administration & dosage. Prednisolone / adverse effects. Prednisolone / therapeutic use. Remission Induction. Rituximab. Virus Activation / drug effects

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  • [Copyright] (c) 2009 Wiley-Liss, Inc.
  • (PMID = 19591223.001).
  • [ISSN] 1545-5017
  • [Journal-full-title] Pediatric blood & cancer
  • [ISO-abbreviation] Pediatr Blood Cancer
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antibodies, Monoclonal; 0 / Antibodies, Monoclonal, Murine-Derived; 0 / Antiviral Agents; 0 / Immunoglobulins, Intravenous; 0 / Immunologic Factors; 0 / Immunosuppressive Agents; 4F4X42SYQ6 / Rituximab; 83HN0GTJ6D / Cyclosporine; 9PHQ9Y1OLM / Prednisolone; X4HES1O11F / Acyclovir
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