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1. Herzig KA, Juffs HG, Norris D, Brown AM, Gill D, Hawley CM, Cobcroft R, Petrie JB, Marlton P, Thomson D, Campbell SB, Nicol DL, Johnson DW: A single-centre experience of post-renal transplant lymphoproliferative disorder. Transpl Int; 2003 Jul;16(7):529-36
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  • [Title] A single-centre experience of post-renal transplant lymphoproliferative disorder.
  • Post-transplant lymphoproliferative disorder (PTLD) complicates 1 to 10% of all transplantations.
  • Previous clinicopathological studies of PTLD have been limited by small numbers, short follow-up times, outdated data, heterogeneity of pooled solid-organ transplant results, and selective inclusion of early-onset disease.
  • We therefore undertake here a retrospective analysis and identify all cases of PTLD that complicated renal transplantation at the Princess Alexandra Hospital between 30 June 1969 and 31 May 2001.
  • Of 2,030 renal transplantation patients, 29 (1.4%) developed PTLD after a median period of 0.5 years (range 0.1 to 23.3 years).
  • PTLD patients were more likely to have received cyclosporine (76% versus 62%, P<0.05), tacrolimus (10% versus 2%, P<0.05) and OKT3 (28% versus 10%, P<0.01).
  • As the burden of immunosuppression increased from dual, to triple, to OKT3 therapy, the risks of early onset, extensive-stage, polymorphic, Epstein-Barr virus (EBV)-associated and fatal PTLD progressively increased.
  • The independent predictors of mortality on multivariate Cox regression were polymorphic histology (HR 7.4, 95% CI 1.5-37) and an international prognostic index (IPI) >1 (HR 2.7, 95% CI 1.1-6.8).
  • Compared with other treatments, chemotherapy was associated with higher survival rates (100% versus 18% at 3 years, P=0.0001).
  • In conclusion, PTLD is more likely, occurs earlier, and is more often fatal, in the setting of intensive immunosuppression.
  • Nevertheless, excellent long-term outcomes are achievable with early recognition and institution of appropriate treatment.
  • [MeSH-major] Kidney Transplantation / adverse effects. Lymphoproliferative Disorders / etiology

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  • (PMID = 12734646.001).
  • [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
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2. 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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3. 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
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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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4. 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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5. Muti G, De Gasperi A, Cantoni S, Oreste P, Gini G, Civati G, Busnach G, Brando B, Frigerio M, Mangiavacchi M, Alberti A, Decarus L, Rondinara G, De Giuli E, Morra E: Incidence and clinical characteristics of posttransplant lymphoproliferative disorders: report from a single center. Transpl Int; 2000;13 Suppl 1:S382-7
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  • [Title] Incidence and clinical characteristics of posttransplant lymphoproliferative disorders: report from a single center.
  • In the period 1973-1998, among 2139 allograft recipients treated with standard immunosuppression, posttransplant lymphoproliferative disorders (PTLD) developed in 19 patients (0.9%): one plasmacytic hyperplasia, two polymorphic PTLD, one myeloma, and 15 lymphomas.
  • PTLD developed 1 year after transplantation (tx) in 14 patients.
  • Five patients were diagnosed at autopsy, 2 were lost to follow up, 3 died before therapy could be instituted, and 1 patient has just started chemotherapy.
  • Of the 8 evaluable patients, 2 received acyclovir and are alive in complete remission (CR) and 6 received chemotherapy +/- surgery.
  • Of these 6, 4 died of lymphoma and/or infection, 1 died of unrelated causes in CR, and 1 is alive in CR.
  • PTLD is a severe complication of tx, usually running an aggressive course which may preclude prompt diagnosis and treatment.
  • Nevertheless, therapy is feasible and must be tailored on the histologic subtype.
  • Seventy-four percent of patients were diagnosed with late-onset PTLD stressing the need for long-term follow up.
  • [MeSH-major] Lymphoproliferative Disorders / epidemiology. Postoperative Complications / epidemiology. Transplantation, Homologous
  • [MeSH-minor] Acyclovir / therapeutic use. Adult. Aged. Antiviral Agents / therapeutic use. Bone Marrow Transplantation. Drug Therapy, Combination. Humans. Immunophenotyping. Immunosuppressive Agents / therapeutic use. Incidence. Italy. Kidney Transplantation. Middle Aged. Organ Transplantation. Retrospective Studies. Time Factors

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  • (PMID = 11112038.001).
  • [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 / Antiviral Agents; 0 / Immunosuppressive Agents; X4HES1O11F / Acyclovir
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6. 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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7. 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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  • [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.
  • In total, 9 patients (52.9%) achieved a complete remission, with a mean duration of 17.8 months.
  • 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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8. Taylor AL, Bowles KM, Callaghan CJ, Wimperis JZ, Grant JW, Marcus RE, Bradley JA: Anthracycline-based chemotherapy as first-line treatment in adults with malignant posttransplant lymphoproliferative disorder after solid organ transplantation. Transplantation; 2006 Aug 15;82(3):375-81
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  • [Title] Anthracycline-based chemotherapy as first-line treatment in adults with malignant posttransplant lymphoproliferative disorder after solid organ transplantation.
  • BACKGROUND: Recommended first-line treatment for posttransplant lymphoproliferative disorder (PTLD) is reduction in immunosuppressive therapy, irrespective of histopathological type.
  • Second-line treatment with chemotherapy is generally reserved for tumors that fail to respond to reduced immunosuppression.
  • In view of the similarities between monomorphic PTLD and non-Hodgkin's lymphoma in the general population, our policy is to treat monomorphic PTLD with anthracycline-based chemotherapy as first-line treatment.
  • METHODS: A retrospective single-center analysis of 18 adults who developed PTLD following liver or kidney transplantation was undertaken, with particular emphasis on tumor histology, treatment received, and clinical outcome.
  • RESULTS: Of the 18 patients with PTLD, 13 had high-grade malignant lymphoma on diagnostic biopsy and received anthracycline-based chemotherapy and reduction in immunosuppression as first-line therapy.
  • There was no graft loss from rejection or drug toxicity.
  • Four (22%) patients had polymorphic PTLD on diagnostic biopsy (of which two were re-classified as monomorphic) and one had a low-grade malignant lymphoma.
  • All five patients were treated by reduction in immunosuppression without chemotherapy and were in complete remission at a median of two years after diagnosis.
  • CONCLUSION: The use of anthracycline-based chemotherapy and reduction of immunosuppression as first-line treatment in adults with monomorphic PTLD is well tolerated and achieves sustained complete remission in around 70% of patients with a low risk of graft loss.
  • [MeSH-major] Anthracyclines / therapeutic use. Kidney Transplantation. Lymphoma / drug therapy. Lymphoma / pathology. Lymphoproliferative Disorders / drug therapy. Lymphoproliferative Disorders / pathology
  • [MeSH-minor] Adolescent. Adult. Aged. Biopsy. Female. Humans. Male. Middle Aged. Survival Rate. Time Factors. Treatment Outcome

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  • (PMID = 16906036.001).
  • [ISSN] 0041-1337
  • [Journal-full-title] Transplantation
  • [ISO-abbreviation] Transplantation
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Anthracyclines
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9. Trappe R, Riess H, Babel N, Hummel M, Lehmkuhl H, Jonas S, Anagnostopoulos I, Papp-Vary M, Reinke P, Hetzer R, Dörken B, Oertel S: Salvage chemotherapy for refractory and relapsed posttransplant lymphoproliferative disorders (PTLD) after treatment with single-agent rituximab. Transplantation; 2007 Apr 15;83(7):912-8
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  • [Title] Salvage chemotherapy for refractory and relapsed posttransplant lymphoproliferative disorders (PTLD) after treatment with single-agent rituximab.
  • BACKGROUND: Single-agent rituximab has demonstrated encouraging efficacy and tolerability in posttransplant lymphoproliferative disorders (PTLDs) failing to respond to immunosuppression reduction (IR).
  • This retrospective analysis was undertaken to determine the efficacy and safety of salvage therapy in recipients of solid organ transplants with progression of PTLD after rituximab first-line therapy.
  • Of these, 10 had received CHOP salvage chemotherapy.
  • Most patients (73%) had late PTLD (median onset of disease 145 months posttransplant), and most (83%) had monomorphic histology; 36% had EBV-association.
  • RESULTS: IR and irradiation therapy re-induced complete remission (CR) and allowed long-term disease control in a patient with polymorphic PTLD relapse.
  • CHOP therapy achieved CR in five (50%) and partial remission (PR) in two (20%) patients.
  • Of the patients achieving PR, one is currently alive, and the second died from transplant rejection after converting to CR after consolidative chemotherapy.
  • Patients with stable disease (two) and progressive disease (one) have died from PTLD.
  • CONCLUSIONS: CHOP salvage therapy achieved a favorable overall response rate of 70% in this setting, indicating that PTLD generally remains chemotherapy-sensitive after progression following first-line rituximab.
  • [MeSH-major] Antibodies, Monoclonal / therapeutic use. Antineoplastic Combined Chemotherapy Protocols / adverse effects. Immunologic Factors / therapeutic use. Kidney Transplantation / immunology. Liver Transplantation / adverse effects. Liver Transplantation / immunology. Lymphoproliferative Disorders / drug therapy. Lymphoproliferative Disorders / etiology. Neoplasms / drug therapy

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  • (PMID = 17460562.001).
  • [ISSN] 0041-1337
  • [Journal-full-title] Transplantation
  • [ISO-abbreviation] Transplantation
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antibodies, Monoclonal; 0 / Antibodies, Monoclonal, Murine-Derived; 0 / Immunologic Factors; 4F4X42SYQ6 / Rituximab; 5J49Q6B70F / Vincristine; 80168379AG / Doxorubicin; 8N3DW7272P / Cyclophosphamide; VB0R961HZT / Prednisone; CHOP protocol
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10. Hayashida M, Ogita K, Matsuura T, Takahashi Y, Nishimoto Y, Ohga S, Hara T, Soejima Y, Taketomi A, Maehara Y, Kohashi K, Tsuneyoshi M, Taguchi T: Successful prolonged rituximab treatment for post-transplant lymphoproliferative disorder following living donor liver transplantation in a child. Pediatr Transplant; 2007 Sep;11(6):671-5
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  • [Title] Successful prolonged rituximab treatment for post-transplant lymphoproliferative disorder following living donor liver transplantation in a child.
  • PTLD is a serious complication of immunosuppression in solid organ transplant recipients.
  • The incidence of PTLD is significantly higher in pediatric recipients than in adult because children are often EBV-seronegative and they may develop primary EBV infection after transplantation.
  • We herein describe a case of GI-PTLD who achieved a complete remission by prolonged rituximab, a chimeric monoclonal antibody against CD20, mono-therapy.
  • A one-yr-old female underwent a LDLT for liver failure after having previously undergone the Kasai procedure for biliary atresia.
  • At sixty days following the transplantation, GI-PTLD developed.
  • A histopathological examination of tumor revealed atypical medium to large cell lymphoid proliferation with strong CD20 immunopositivity indicating their B-cell origin.
  • Polymorphic PTLD was diagnosed.
  • Based on this case, rituximab appears to be beneficial as a first-line therapy for PTLD.
  • [MeSH-major] Antibodies, Monoclonal / administration & dosage. Liver Transplantation / adverse effects. Lymphoproliferative Disorders / drug therapy. Lymphoproliferative Disorders / etiology
  • [MeSH-minor] Antibodies, Monoclonal, Murine-Derived. Female. Humans. Infant. Living Donors. Remission Induction. Rituximab. Time Factors

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  • [CommentIn] Pediatr Transplant. 2007 Sep;11(6):575-7 [17663676.001]
  • (PMID = 17663692.001).
  • [ISSN] 1397-3142
  • [Journal-full-title] Pediatric transplantation
  • [ISO-abbreviation] Pediatr Transplant
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Denmark
  • [Chemical-registry-number] 0 / Antibodies, Monoclonal; 0 / Antibodies, Monoclonal, Murine-Derived; 4F4X42SYQ6 / Rituximab
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11. Milpied N, Vasseur B, Parquet N, Garnier JL, Antoine C, Quartier P, Carret AS, Bouscary D, Faye A, Bourbigot B, Reguerre Y, Stoppa AM, Bourquard P, Hurault de Ligny B, Dubief F, Mathieu-Boue A, Leblond V: Humanized anti-CD20 monoclonal antibody (Rituximab) in post transplant B-lymphoproliferative disorder: a retrospective analysis on 32 patients. Ann Oncol; 2000;11 Suppl 1:113-6
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  • [Title] Humanized anti-CD20 monoclonal antibody (Rituximab) in post transplant B-lymphoproliferative disorder: a retrospective analysis on 32 patients.
  • BACKGROUND: B-lymphoproliferative post-transplant disorder (BLPD) is a severe complication of organ and bone marrow transplantation.
  • The reduction of immuno-suppressive therapy or surgery for localized disease may cure some BLPDs.
  • Other therapeutic approaches such as chemotherapy and antiviral drugs are toxic and of limited efficacy.
  • Adoptive immunotherapy with donor T-cell infusions has yielded promising results but is, at the present time, easily applicable only in bone marrow-transplanted patients.
  • Anti-B-cell Murine monoclonal antibodies (MoAbs) have proven effective but are no longer available for human use.
  • In organ recipients, tumors were classified as polymorphic and monomorphic in 10 and 15 cases, respectively; 4 of 6 bone marrow transplant recipients were treated without pathology documentation because of a rise in EBV load, fever and lymph node enlargement.
  • Rituximab was used as first-line therapy in 30 patients (after reduction of immunosuppressive treatment in 27 patients) and as salvage therapy in 2 patients (after failure of chemotherapy).
  • The median time from diagnosis of BLPD to treatment with Rituximab was 14 days (1-110 days).
  • In solid organ transplant the response rate was 65% (15 CR and 2 PR) while it was 83% in bone marrow-transplanted patients (5 CR).
  • With a median follow-up of 8 months (1-16 months) 24 patients are still alive.
  • Of the 22 patients who achieved response, 15 patients (11 solid organ transplant and 4 bone marrow transplant) are alive with no evidence of disease, 4 patients relapsed a median of 7 months (3-10 months) after treatment and 3 died while in CR of concurrent diseases.
  • Of the 10 patients who did not respond to Rituximab 5 are alive with no evidence of disease after salvage therapy.
  • CONCLUSIONS: The use of rituximab appears to be a safe and relatively efficient therapy in BLPDs.

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  • (PMID = 10707791.001).
  • [ISSN] 0923-7534
  • [Journal-full-title] Annals of oncology : official journal of the European Society for Medical Oncology
  • [ISO-abbreviation] Ann. Oncol.
  • [Language] ENG
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antibodies, Monoclonal; 0 / Antibodies, Monoclonal, Murine-Derived; 0 / Antineoplastic Agents; 4F4X42SYQ6 / Rituximab
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12. Tsai DE, Aqui NA, Tomaszewski JE, Olthoff KM, Ahya VN, Kotloff RM, Bloom RD, Brozena SC, Hodinka RL, Stadtmauer EA, Schuster SJ, Nasta SD, Porter DL, Luger SM, Klumpp TR: Serum protein electrophoresis abnormalities in adult solid organ transplant patients with post-transplant lymphoproliferative disorder. Clin Transplant; 2005 Oct;19(5):644-52
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  • [Title] Serum protein electrophoresis abnormalities in adult solid organ transplant patients with post-transplant lymphoproliferative disorder.
  • Post-transplant lymphoproliferative disorder (PTLD) is an Epstein-Barr virus (EBV) associated malignancy that occurs in the setting of pharmacologic immunosuppression used after organ transplantation.
  • The presence of monoclonal gammopathy (MG) after organ transplantation is a risk factor for the development of PTLD.
  • We retrospectively explored the characteristics of serum protein electrophoresis (SPEP) in 38 adult solid organ transplant patients with biopsy proven PTLD and SPEP.
  • Hypogammaglobulinemia was correlated with the presence of MG (p = 0.01) and polymorphic B-cell hyperplasia histology (p = 0.01).
  • Persistence of MG after complete response of the PTLD did not predict relapse.
  • There is a high incidence of MG and gammaglobulin abnormalities in patients with PTLD.
  • [MeSH-major] Blood Proteins / analysis. Lymphoproliferative Disorders / blood. Organ Transplantation / adverse effects
  • [MeSH-minor] Adult. Aged. Biomarkers / blood. Biopsy, Needle. Electrophoresis. Female. Flow Cytometry. Follow-Up Studies. Graft Rejection / drug therapy. Humans. Immunosuppressive Agents / adverse effects. Immunosuppressive Agents / therapeutic use. Male. Middle Aged. Prognosis. Retrospective Studies. Severity of Illness Index

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  • (PMID = 16146557.001).
  • [ISSN] 0902-0063
  • [Journal-full-title] Clinical transplantation
  • [ISO-abbreviation] Clin Transplant
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Denmark
  • [Chemical-registry-number] 0 / Biomarkers; 0 / Blood Proteins; 0 / Immunosuppressive Agents
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13. 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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  • [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).
  • The morphologic, immunophenotypic, genotypic, and clinical features of the EBV-negative PTLDs were reviewed, and selected features were compared with EBV-positive cases.
  • 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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14. Marino D, Burra P, Boccagni P, Calabrese F, Canova F, Trentin C, Boso C, Soldà C, Angeli P, Aversa SM: Post-transplant lymphoproliferative disorders in liver transplanted patients: a single-centre experience. Anticancer Res; 2010 Jun;30(6):2383-91
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  • [Title] Post-transplant lymphoproliferative disorders in liver transplanted patients: a single-centre experience.
  • Post-transplant lymphoproliferative disorder (PTLD) is a life-threatening complication after solid organ transplantation.
  • Reduction of immunosuppression (RI) is accepted as a first step treatment with a long-term complete response rate observed in 23-50% of patients.
  • Chemotherapy for diseases refractory to RI is based on small cohorts treated with different regimens.
  • This paper reports on 10 consecutive cases of PTLD after liver transplantation.
  • The median time from transplantation to PTLD diagnosis was 5 years.
  • PTLD was frequently extranodal involving the transplanted liver.
  • Seven monomorphic PTLD, 2 polymorphic and one Hodgkin disease were observed.
  • Epstein Barr virus was present in tumour tissue only in one case.
  • Initial therapy included RI in all patients.
  • Chemotherapy was used in eight patients.
  • No treatment-related mortality was observed and no patient developed graft rejection during chemotherapy.
  • [MeSH-major] Liver Transplantation / adverse effects. Lymphoproliferative Disorders / etiology
  • [MeSH-minor] Adult. Antibodies, Monoclonal / therapeutic use. Antibodies, Monoclonal, Murine-Derived. Female. Herpesvirus 4, Human / isolation & purification. Humans. Male. Middle Aged. Risk Factors. Rituximab. Survival Rate

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  • (PMID = 20651397.001).
  • [ISSN] 1791-7530
  • [Journal-full-title] Anticancer research
  • [ISO-abbreviation] Anticancer Res.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Greece
  • [Chemical-registry-number] 0 / Antibodies, Monoclonal; 0 / Antibodies, Monoclonal, Murine-Derived; 4F4X42SYQ6 / Rituximab
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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
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16. Timurağaoğlu A, Uğur-Bilgin A, Colak D, Tuncer M, Gölbaşi I, Hazar V, Kiliçarsłan B, Undar L, Demirbaş A: Posttransplant lymphoproliferative disorders in transplant recipients. Transplant Proc; 2006 Mar;38(2):641-5
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  • [Title] Posttransplant lymphoproliferative disorders in transplant recipients.
  • Posttransplant lymphoproliferative disorder (PTLD) is a serious complication of organ transplantation, with a reported incidence between 0.8% and 32%.
  • The incidence of PTLD mainly depends on the transplanted organ, the immunosuppressive drugs, the viral serology, and the age of the recipient.
  • The aim of our study was to analyze our patients diagnosed with PTLD.
  • Among 1040 transplantations, including 931 renal, 14 heart, 55 liver and 40 allogeneic peripheral blood stem cell (PBSC), 8 patients (7 male, 1 female) were diagnosed with PTLD.
  • According to the World Health Organization classification system, six patients were diagnosed as diffuse large B-cell lymphoma, one patient Burkitt's lymphoma, and one polymorphic PTLD.
  • At the time of diagnosis, 7 patients showed positive Epstein-Barr virus (EBV) and cytomegalovirus (CMV) Ig G and negative Ig M; one patient, positive EBV Ig M and negative CMV Ig G and M.
  • One of these patient's pathologic tissue revealed positive EBV DNA, which was not detected in six of the other eight patients.
  • This patient was an 8-year-old boy diagnosed with Burkitt's lymphoma at 31 months after liver transplantation.
  • Seven patients died of disease or complications of chemotherapy.
  • Only one patient survived after the diagnosis of PTLD.
  • In conclusion, even with treatment the mortality rate was high among our patients with PTLD.
  • To decrease the incidence of PTLD and related mortality, risk factors must be evaluated in multicenter studies.
  • [MeSH-major] Lymphoproliferative Disorders / epidemiology. Postoperative Complications / epidemiology. Transplantation Immunology
  • [MeSH-minor] Adult. Child. Female. Heart Transplantation / immunology. Humans. Immunosuppressive Agents / therapeutic use. Incidence. Kidney Transplantation / immunology. Liver Transplantation / immunology. Male. Middle Aged. Stem Cell Transplantation

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  • (PMID = 16549195.001).
  • [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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17. 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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18. 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.
  • RESULTS: There were eight men and three women with a mean age of 49 years.
  • 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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19. 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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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [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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  • [Cites] Histopathology. 2000 Jan;36(1):69-86 [10632755.001]
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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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20. Dotti G, Fiocchi R, Motta T, Gamba A, Gotti E, Gridelli B, Borleri G, Manzoni C, Viero P, Remuzzi G, Barbui T, Rambaldi A: Epstein-Barr virus-negative lymphoproliferate disorders in long-term survivors after heart, kidney, and liver transplant. Transplantation; 2000 Mar 15;69(5):827-33
NCI CPTC Antibody Characterization Program. NCI CPTC Antibody Characterization Program .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Epstein-Barr virus-negative lymphoproliferate disorders in long-term survivors after heart, kidney, and liver transplant.
  • BACKGROUND: Solid organ transplant patients undergoing long-term immunosuppression have high risk of developing lymphomas.
  • The pathogenesis of the late-occurring posttransplantation lymphoproliferative disorders (PTLD) have not yet been extensively investigated.
  • METHODS: We studied 15 patients who developed PTLD after a median of 79 months (range 22-156 months) after organ transplant.
  • RESULTS: All monomorphic PTLD and two of three polymorphic PTLD showed a monoclonal pattern.
  • Within monomorphic PTLD, the EBV-positive lymphomas were even lower (31%).
  • The modulation of immunosuppression was ineffective in all patients with monomorphic PTLD independent of the presence of the EBV genome.
  • The clinical outcome after chemotherapy was poor because of infectious complications and resistant disease.
  • With a median follow-up of 4 months, the median survival time of these patients was 7 months.
  • CONCLUSIONS: Late occurring lymphomas could be considered an entity distinct from PTLD, occurring within 1 year of transplant, because they show a histological and clinical presentation similar to lymphomas of immunocompetent subjects, are frequently negative for the EBV genome, are invariably clonal, and may rearrange the c-myc oncogene.
  • New therapeutic strategies are required to reduce the mortality rate, and new modalities of long-lasting immunosuppression are called for.
  • [MeSH-major] Heart Transplantation. Herpesvirus 4, Human / isolation & purification. Kidney Transplantation. Liver Transplantation. Lymphoproliferative Disorders / etiology. Lymphoproliferative Disorders / virology. Postoperative Complications
  • [MeSH-minor] Adolescent. Adult. Aged. Child, Preschool. Female. Genome, Viral. Humans. Male. Middle Aged. Postoperative Period. Survival Analysis. Time Factors. Treatment Outcome


21. Knight JS, Tsodikov A, Cibrik DM, Ross CW, Kaminski MS, Blayney DW: Lymphoma after solid organ transplantation: risk, response to therapy, and survival at a transplantation center. J Clin Oncol; 2009 Jul 10;27(20):3354-62
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Lymphoma after solid organ transplantation: risk, response to therapy, and survival at a transplantation center.
  • PURPOSE: We studied the incidence, risk factors, treatment, and outcomes of post-transplantation lymphoproliferative disorder (PTLD) that occurred at the University of Michigan since 1964.
  • PATIENTS AND METHODS: We identified 7,040 patients who received solid organ transplantation (SOT) and post-transplantation immunosuppressive therapy.
  • Seventy-eight patients developed PTLD.
  • RESULTS: Diffuse large B-cell lymphoma (n = 43), polymorphic PTLD (n = 10), Hodgkin's lymphoma (n = 7), Burkitts lymphoma (n = 6), plasmacytoma (n = 5), and mucosa-associated lymphoid tissue lymphoma (n = 3) were all over-represented in the SOT population compared with a population sample from the Surveillance, Epidemiology, and End Results (SEER) database; follicular lymphoma (n = 0) was underrepresented.
  • Negative pretransplantation Epstein-Barr virus (EBV) serology was a risk factor for PTLD.
  • Available histologic analysis of tumor tissue showed that 75% were CD20 positive and that 62% were EBV positive; EBV-positive tumors occurred sooner after SOT than EBV-negative tumors (mean, 29 v 66 months).
  • Extralymphatic disease (79%), poor performance status (68%), elevated lactate dehydrogenase (LDH; 71%), and advanced stage (68%) disease were all common at the time of lymphoma diagnosis.
  • Two thirds of patients had a complete response when treated with cyclophosphamide, doxorubicin, vincristine, and prednisone-like chemotherapy (either with or without rituximab).
  • Median overall survival in all patients with PTLD was 8.23 years (95% CI, 2.28 to 30.0 years).
  • CONCLUSION: EBV-naïve patients who receive a donor organ from an EBV-infected donor are in the highest-risk situation for PTLD development.
  • Follicular lymphoma is unusual.
  • With treatment, survival of patients with PTLD was indistinguishable from that of the SEER population sample.
  • [MeSH-major] Lymphoma / etiology. Lymphoproliferative Disorders / etiology. Organ Transplantation / adverse effects
  • [MeSH-minor] Adolescent. Adult. Aged. Epstein-Barr Virus Infections / complications. Epstein-Barr Virus Infections / virology. Female. Herpesvirus 4, Human / genetics. Herpesvirus 4, Human / metabolism. Humans. Immunohistochemistry. Immunosuppressive Agents / adverse effects. Immunosuppressive Agents / therapeutic use. In Situ Hybridization. Kaplan-Meier Estimate. Male. Michigan. Middle Aged. RNA, Viral / genetics. Risk Factors. Tacrolimus / adverse effects. Tacrolimus / therapeutic use. Treatment Outcome. Viral Matrix Proteins / metabolism

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  • (PMID = 19451438.001).
  • [ISSN] 1527-7755
  • [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 / EBV-associated membrane antigen, Epstein-Barr virus; 0 / Immunosuppressive Agents; 0 / RNA, Viral; 0 / Viral Matrix Proteins; WM0HAQ4WNM / Tacrolimus
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22. 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


23. Pinho-Apezzato ML, Tannuri U, Tannuri AC, Mello ES, Lima F, Gibelli NE, Santos MM, Ayoub AA, Maksoud-Filho JG, Velhote MC, Silva MM, Andrade WC, Miyatani HT: Multiple clinical presentations of lymphoproliferative disorders in pediatric liver transplant recipients: a single-center experience. Transplant Proc; 2010 Jun;42(5):1763-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Multiple clinical presentations of lymphoproliferative disorders in pediatric liver transplant recipients: a single-center experience.
  • Posttransplantation lymphoproliferative disorder (PTLD) is a serious complication following solid organ transplantation that has been linked to Epstein-Barr virus (EBV) infection.
  • The aim of this article was to describe a single-center experience with the multiplicity of clinical presentations of PTLD.
  • Among 350 liver transplantations performed in 303 children, 13 survivor children displayed a histological diagnosis of PTLD (13/242 survivors; 5.4%).
  • The age at diagnosis ranged from 12 to 258 months (median, 47), and the time from transplantation ranged from 1 to 84 months (median, 13).
  • The clinical signs at presentation were anemia (92.3%), diarrhea and vomiting (69.2%), recurrent upper airway infections (38.4%), Waldeyer ring lymphoid tissue hypertrophy (23.0%), abdominal mass lesions (30.7%), massive cervical and mediastinal adenopathy (15.3%), or gastrointestinal and respiratory symptoms (30.7%).
  • One child developed fulminant hepatic allograft failure secondary to graft involvement by PTLD.
  • Polymorphic PTLD was diagnosed in 6 patients; 7 had the diagnosis of lymphoma.
  • Treatment consisted of stopping immunosuppression as well as starting intravenous gancyclovir and anti-CD20 monoclonal antibody therapy.
  • The clinical presentation of PTLD varied from fever of unknown origin to fulminant hepatic failure.
  • The other symptoms that may be linked to the diagnosis of PTLD are pancytopenia, tonsil and adenoid hypertrophy, cervical or mediastinal lymph node enlargement, as well as abdominal masses.
  • Despite numerous advances, the optimal treatment approach for PTLD is not completely known and the mortality rate is still high.
  • [MeSH-major] Liver Transplantation / adverse effects. Lymphoproliferative Disorders / diagnosis. Postoperative Complications / pathology
  • [MeSH-minor] Biliary Atresia / surgery. Child. Child, Preschool. Colonic Neoplasms / pathology. Cyclosporine / therapeutic use. Drug Therapy, Combination. Epstein-Barr Virus Infections / epidemiology. Female. Herpesvirus 4, Human / isolation & purification. Humans. Immunosuppressive Agents / therapeutic use. Infant. Lymph Nodes / pathology. Lymphoma, B-Cell / pathology. Male. Prednisone / therapeutic use. Retrospective Studies. Survivors. Tacrolimus / therapeutic use

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  • (PMID = 20620519.001).
  • [ISSN] 1873-2623
  • [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; 83HN0GTJ6D / Cyclosporine; VB0R961HZT / Prednisone; WM0HAQ4WNM / Tacrolimus
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24. Al-Akash SI, Al Makadma AS, Al Omari MG: Rapid response to rituximab in a pediatric liver transplant recipient with post-transplant lymphoproliferative disease and maintenance with sirolimus monotherapy. Pediatr Transplant; 2005 Apr;9(2):249-53
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Rapid response to rituximab in a pediatric liver transplant recipient with post-transplant lymphoproliferative disease and maintenance with sirolimus monotherapy.
  • A 12-yr-old girl with end-stage renal disease secondary to primary hyperoxaluria type I received a living related (left lateral segment) liver transplant from her brother as the first step of a staged liver and kidney transplant.
  • Nine weeks after transplantation she developed polymorphic PTLD of the tonsils and adenoids.
  • Initial treatment with surgical resection and withdrawal of immunosuppression was insufficient as she developed recurrence of the PTLD lesion 1 wk after surgical resection and reduction of immunsuppression.
  • Treatment with the chimeric monoclonal anti CD20 antibody, rituximab (Mabthera, Hoffman-La Roche AG, Grenzach-Whylen, Germany), resulted in quick response and complete recovery from PTLD within 2 wk, with no recurrence up to 8 months after treatment.
  • [MeSH-major] Antibodies, Monoclonal / therapeutic use. Immunologic Factors / therapeutic use. Immunosuppressive Agents / therapeutic use. Kidney Failure, Chronic / surgery. Liver Transplantation. Lymphoproliferative Disorders / drug therapy. Sirolimus / therapeutic use


25. Tamai K, Koyama T, Saga T, Umeoka S, Aoyama A, Hanaoka N, Fukuse T, Wada H, Tachibana M, Togashi K: Posttransplant lymphoproliferative disorder in a lung transplant recipient. J Thorac Imaging; 2005 Nov;20(4):280-3
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  • [Title] Posttransplant lymphoproliferative disorder in a lung transplant recipient.
  • The authors describe a case of posttransplant lymphoproliferative disorder (PTLD) in a 38-year-old Japanese male patient who had undergone bilateral lung transplantation.
  • Transcutaneous lung biopsy was performed, yielding a diagnosis of polymorphic PTLD positive for Epstein-Barr virus (EBV)-encoded RNA (EBER) and CD20.
  • Treatment with rituximab was successful, resulting in decreased size and number of lung nodules.
  • In this case, CT and FDG-PET were useful for initial diagnosis and evaluation of treatment response.
  • To the best of our knowledge, this is the first report of PTLD in a lung transplant recipient in Japan documented in the English literature.
  • [MeSH-major] Epstein-Barr Virus Infections / radiography. Epstein-Barr Virus Infections / radionuclide imaging. Lung Transplantation. Lymphoproliferative Disorders / radiography. Lymphoproliferative Disorders / radionuclide imaging
  • [MeSH-minor] Adult. Antibodies, Monoclonal / therapeutic use. Antibodies, Monoclonal, Murine-Derived. Antigens, CD20 / analysis. Biopsy. Fluorodeoxyglucose F18. Humans. Male. Postoperative Complications / drug therapy. Postoperative Complications / radiography. Postoperative Complications / radionuclide imaging. Radiopharmaceuticals. Rituximab. Tomography, Emission-Computed. Tomography, X-Ray Computed

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  • (PMID = 16282905.001).
  • [ISSN] 0883-5993
  • [Journal-full-title] Journal of thoracic imaging
  • [ISO-abbreviation] J Thorac Imaging
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antibodies, Monoclonal; 0 / Antibodies, Monoclonal, Murine-Derived; 0 / Antigens, CD20; 0 / Radiopharmaceuticals; 0Z5B2CJX4D / Fluorodeoxyglucose F18; 4F4X42SYQ6 / Rituximab
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