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Items 1 to 37 of about 37
1. 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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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. 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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  • (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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4. Buadi FK, Heyman MR, Gocke CD, Rapoport AP, Hakimian R, Bartlett ST, Sarkodee-Adoo C: Treatment and outcomes of post-transplant lymphoproliferative disease: a single institution study. Am J Hematol; 2007 Mar;82(3):208-14
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Treatment and outcomes of post-transplant lymphoproliferative disease: a single institution study.
  • Post-transplant lymphoproliferative disorders (PTLD) complicate up to 10% of solid organ transplants.
  • This retrospective study was conducted to review the PTLD experience among 2,300 recipients of solid organ or allogeneic bone marrow transplants from a single institution.
  • Twenty-seven cases of PTLD were identified, leading to an overall incidence of 1.2%.
  • Polymorphic B cell hyperplasia/lymphoma was the most common type.
  • The median time to development of PTLD was 8.4 months.
  • Ten patients had localized (stage I or II) disease, and 12 patients presented with B symptoms.
  • Nine patients each were treated with systemic chemotherapy or surgical resection as part of the initial therapy.
  • There were no late relapses of PTLD, and 17 patients remain alive.
  • Age, sex, organ source, LDH, stage, presence of extranodal disease, or presentation with B symptoms did not influence overall survival when examined by Cox proportional hazard model.
  • Thirteen patients retained their graft function throughout PTLD treatment.
  • This study confirms the ability to treat a significant proportion of PTLD patients with chemotherapy or surgical resection (depending on presentation), without sacrificing graft function in those receiving chemotherapy.
  • [MeSH-major] Lymphoproliferative Disorders. Organ Transplantation / adverse effects
  • [MeSH-minor] Adult. Aged. Antineoplastic Agents / therapeutic use. Antiviral Agents / administration & dosage. Antiviral Agents / therapeutic use. Disease-Free Survival. Female. Graft Rejection / complications. Graft Rejection / prevention & control. Humans. Immunoglobulins, Intravenous / therapeutic use. Immunosuppressive Agents / administration & dosage. Immunosuppressive Agents / adverse effects. Immunosuppressive Agents / therapeutic use. Male. Middle Aged. Radiotherapy. Reoperation. Retrospective Studies. Treatment Outcome

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  • [Copyright] Copyright (c) 2006 Wiley-Liss, Inc.
  • (PMID = 17022049.001).
  • [ISSN] 0361-8609
  • [Journal-full-title] American journal of hematology
  • [ISO-abbreviation] Am. J. Hematol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Antiviral Agents; 0 / Immunoglobulins, Intravenous; 0 / Immunosuppressive Agents
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5. Arita H, Izumoto S, Kinoshita M, Okita Y, Hashimoto N, Fujita T, Ichimaru N, Takahara S, Yoshimine T: Posttransplant lymphoproliferative disorders of the central nervous system after kidney transplantation: single center experience over 40 years. Two case reports. Neurol Med Chir (Tokyo); 2010;50(12):1079-83
Hazardous Substances Data Bank. MYCOPHENOLATE MOFETIL .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Posttransplant lymphoproliferative disorders of the central nervous system after kidney transplantation: single center experience over 40 years. Two case reports.
  • Posttransplant lymphoproliferative disorder (PTLD) is one of the life-threatening complications of organ transplantation.
  • PTLD sometimes involves the central nervous system (CNS), but the clinical characteristics are not well recognized.
  • Two of the 631 patients (0.32%) developed CNS PTLD.
  • A 40-year-old Japanese woman suffered onset of CNS PTLD 5 years after renal transplantation.
  • She underwent second biopsy and the diagnosis was recurrent CNS PTLD.
  • A 61-year-old woman suffered onset of CNS PTLD 19 years after renal transplantation.
  • Histological examination showed polymorphic-type PTLD in both cases.
  • The first case of polymorphic CNS PTLD was successfully treated by modulation of immunosuppressants without radiation therapy even at recurrence.
  • PTLD should be included in the differential diagnosis of brain tumors in recipients of solid organ transplantation, and histological subtype should be carefully identified to establish the correct treatment strategy.
  • [MeSH-major] Central Nervous System Diseases / pathology. Immunosuppressive Agents / adverse effects. Kidney Transplantation / adverse effects. Lymphoproliferative Disorders / pathology
  • [MeSH-minor] Adult. B-Lymphocytes / pathology. Dose-Response Relationship, Drug. Female. Humans. Middle Aged. Mycophenolic Acid / administration & dosage. Mycophenolic Acid / analogs & derivatives. Steroids / administration & dosage. Steroids / adverse effects. T-Lymphocytes / pathology. Treatment Outcome

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  • (PMID = 21206182.001).
  • [ISSN] 1349-8029
  • [Journal-full-title] Neurologia medico-chirurgica
  • [ISO-abbreviation] Neurol. Med. Chir. (Tokyo)
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Immunosuppressive Agents; 0 / Steroids; 9242ECW6R0 / mycophenolate mofetil; HU9DX48N0T / Mycophenolic Acid
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6. 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
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  • [Other-IDs] NLM/ PMC1208867
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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
Hazardous Substances Data Bank. RITUXIMAB .

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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. 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
Hazardous Substances Data Bank. RITUXIMAB .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [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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9. 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
Hazardous Substances Data Bank. RITUXIMAB .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [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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10. 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
Hazardous Substances Data Bank. RITUXIMAB .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [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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11. 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
Hazardous Substances Data Bank. SIROLIMUS .

  • [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


12. Ohta H, Fukushima N, Ozono K: Pediatric post-transplant lymphoproliferative disorder after cardiac transplantation. Int J Hematol; 2009 Sep;90(2):127-36
MedlinePlus Health Information. consumer health - Heart Transplantation.

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [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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13. 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


14. 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
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] 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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15. 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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16. 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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  • [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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17. Evens AM, David KA, Helenowski I, Kircher SM, Mauro L, Gimelfarb A, Hattersley E, Shammo JM, Smith SE, Smith SM: Multicenter analysis of 81 solid organ transplant (SOT) recipients with posttransplantation lymphoproliferative disease (PTLD): Examination of survival and prognostic factors. J Clin Oncol; 2009 May 20;27(15_suppl):8510

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  • [Title] Multicenter analysis of 81 solid organ transplant (SOT) recipients with posttransplantation lymphoproliferative disease (PTLD): Examination of survival and prognostic factors.
  • : 8510 Background: PTLD has a reported 3-year (yr) overall survival (OS) of 35-40% (Leblond, JCO 2001).
  • The impact of rituximab (RTX) on the prognosis or outcome of PTLD is not known.
  • METHODS: We examined the clinical features, treatment, and outcomes among a large population-based cohort of SOT-related PTLD patients (pts) at 4 Chicago institutions (1/98-2/08).
  • RESULTS: 81 PTLD pts were identified (SOT: 47 kidney ± pancreas, 4 pancreas, 17 liver, 8 heart, 5 lung) with median age at diagnosis (dx) of 48 yrs (range 20-72).
  • Median time from SOT to PTLD was 42 months (mo) (range 1-216 mo).
  • PTLD dx (per WHO) were 55 monomorphic, 22 polymorphic and 4 plasmacytic, while 42 were EBV+ and 30 EBV-negative (9 unknown).
  • 74% of pts (60/81) were treated with rituximab ± chemotherapy (and reduction of immune suppression).
  • Pts receiving RTX as part of therapy had 3-yr PFS of 69% and OS 71% (vs 21% (p=0.0002) and 33% (p=0.001), respectively, without RTX).
  • 1) PS, 2) serum albumin, 3) >1 EN site, 4) marrow involvement, 5) CNS disease and 6) RTX as part of initial therapy.
  • CONCLUSIONS: This study represents the largest PTLD report in RTX-treated pts.
  • We are the first to identify the prognostic significance of low albumin and a low PTLD relapse rate beyond 1 yr (6.3%).
  • Further, it appears that the introduction of RTX has improved the survival of PTLD.

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  • (PMID = 27960875.001).
  • [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
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18. 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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19. Dharnidharka VR, Douglas VK, Hunger SP, Fennell RS: Hodgkin's lymphoma after post-transplant lymphoproliferative disease in a renal transplant recipient. Pediatr Transplant; 2004 Feb;8(1):87-90
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  • [Title] Hodgkin's lymphoma after post-transplant lymphoproliferative disease in a renal transplant recipient.
  • Lymphoid malignancies such as post-transplant lymphoproliferative disease (PTLD) are a major complication of solid organ transplantation.
  • Hodgkin's lymphoma (HL) is not part of the typical spectrum of PTLD, but has rarely been reported as a separate complication.
  • We report a case of HL occurring after previous PTLD in a renal transplant recipient.
  • A 9-yr-old girl with end-stage autosomal recessive polycystic kidney disease received a cadaveric renal transplant at 1 yr of age.
  • She developed polymorphic PTLD localized to the bone marrow at 6 yr post-transplant.
  • No chemotherapy or anti-B cell antibody was administered.
  • The PTLD resolved and kidney graft function remained stable.
  • At 9 yr post-transplant, she presented again with fever of 2 wk duration, associated with enlarged lymph nodes at multiple sites.
  • She was treated with standard combination chemotherapy for HL with COPP/ABV.
  • RS like cells have been reported in the setting of PTLD, but these cells possess an activated B cell phenotype, are EBV negative and CD15 negative.
  • True HL following PTLD has been reported in only three previous cases, with good response to standard chemotherapy in each.
  • [MeSH-major] Epstein-Barr Virus Infections / complications. Hodgkin Disease / virology. Immunosuppression / adverse effects. Kidney Transplantation. Lymphoproliferative Disorders / etiology


20. 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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  • [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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21. 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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  • [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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22. Halkos ME, Miller JI, Mann KP, Miller DL, Gal AA: Thoracic presentations of posttransplant lymphoproliferative disorders. Chest; 2004 Dec;126(6):2013-20
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  • [Title] Thoracic presentations of posttransplant lymphoproliferative disorders.
  • BACKGROUND: Posttransplant lymphoproliferative disorders (PTLDs) are rare complications following transplantation.
  • METHODS: Eleven cases of PTLD with a primary thoracic presentation were identified among 3,085 solid-organ transplant patients and 1,662 bone marrow transplant patients from 1990 to 2001.
  • 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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23. Hayashi RJ, Kraus MD, Patel AL, Canter C, Cohen AH, Hmiel P, Howard T, Huddleston C, Lowell JA, Mallory G Jr, Mendeloff E, Molleston J, Sweet S, DeBaun MR: Posttransplant lymphoproliferative disease in children: correlation of histology to clinical behavior. J Pediatr Hematol Oncol; 2001 Jan;23(1):14-8
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  • [Title] Posttransplant lymphoproliferative disease in children: correlation of histology to clinical behavior.
  • PURPOSE: To determine whether the morphologic features of posttransplant lymphoproliferative disease (PTLD) correlated to a response to therapy.
  • PATIENTS AND METHODS: We reviewed our experience with PTLD in the pediatric population.
  • We identified 32 patients with a total of 36 episodes of PTLD.
  • The diagnosis was confirmed by tissue examination and classified according to the degree of monomorphic features of the lesion.
  • Chemotherapy was used to treat 10 of 15 patients who had progressive disease, and their subsequent course was also analyzed.
  • RESULTS: Sixteen of 17 (94%) patients with polymorphic morphology responded to immunosuppression reduction compared with only 5 of 17 (29%) patients with monomorphic features (P < 0.001).
  • All of the patients with progressive disease who did not receive additional therapy died.
  • Standard chemotherapy regimens for lymphoma were administered to 10 patients with progressive disease, with a high response rate (90%), durable remissions, and acceptable toxicity.
  • CONCLUSIONS: We conclude that the morphologic characteristics of PTLD provide information to potentially help guide treatment strategies in the management of this disease.
  • Standard chemotherapy regimens for malignant lymphoma appear to be a viable treatment option for patients with progressive disease, although further investigation is needed.
  • [MeSH-major] Antiviral Agents / therapeutic use. Immunosuppressive Agents / adverse effects. Lymphoproliferative Disorders / etiology. Lymphoproliferative Disorders / therapy. Organ Transplantation. Postoperative Complications
  • [MeSH-minor] Adolescent. Antineoplastic Agents / therapeutic use. Child. Child, Preschool. Continental Population Groups. Drug Therapy, Combination. Female. Humans. Lymphoma / drug therapy. Male. Retrospective Studies

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  • [CommentIn] J Pediatr Hematol Oncol. 2001 Jan;23(1):7-9 [11196278.001]
  • (PMID = 11196263.001).
  • [ISSN] 1077-4114
  • [Journal-full-title] Journal of pediatric hematology/oncology
  • [ISO-abbreviation] J. Pediatr. Hematol. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Multicenter Study
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Antiviral Agents; 0 / Immunosuppressive Agents
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24. 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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25. 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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26. Boudová L, Fakan F, Michal M, Dusek J, Curík R, Husek K, Voska L, Kolník P, Mukensnabl P, Hes O, Jindra P: [Lymphoproliferative disease after transplantation]. Cesk Patol; 2002 Jan;38(1):24-32
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  • [Title] [Lymphoproliferative disease after transplantation].
  • Herein we describe 7 cases of posttransplantation lymphoproliferative disease (PTLD), 5 in men and 2 in women (aged from 25 to 62 years), occurring from 4 months to 12 years (mean, 7 years) after transplantation.
  • Four cases were diagnosed as monomorphic and three as polymorphic type of PTLD according to the WHO classification.
  • Monoclonal immunoglobuline heavy chain gene rearrangement was detected in two monomorphic lesions and one polymorphic lesion by polymerase chain reaction (PCR).
  • In the two cases of polymorphic and the one case of monomorphic PTLD, the presence of EBV was visualised by immunohistochemical staining of some transformed lymphoid cells for latent membrane protein (LMP) of EBV.
  • The presence of type A EBV was demonstrated by PCR.
  • The patients were treated by reduction or discontinuation of immunosuppression and by chemotherapy.
  • In 2 cases, a part of the organ affected by lymphoma (sigmoid colon and pancreas) was surgically resected.
  • Four patients died of causes related to PTLD (2 to 15 months after the diagnosis), mainly of infectious complications.
  • Only the youngest man is alive and in the complete remission 10 months after the diagnosis of PTLD.
  • [MeSH-major] Lymphoproliferative Disorders / etiology. Transplantation / adverse effects

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  • (PMID = 11933458.001).
  • [ISSN] 1210-7875
  • [Journal-full-title] Československá patologie
  • [ISO-abbreviation] Cesk Patol
  • [Language] cze
  • [Publication-type] English Abstract; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Czech Republic
  • [Chemical-registry-number] 0 / Immunoglobulin Heavy Chains; 0 / Immunosuppressive Agents
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27. Patel H, Vogl DT, Aqui N, Shaked A, Olthoff K, Markmann J, Reddy R, Stadtmauer EA, Schuster S, Tsai DE: Posttransplant lymphoproliferative disorder in adult liver transplant recipients: a report of seventeen cases. Leuk Lymphoma; 2007 May;48(5):885-91
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  • [Title] Posttransplant lymphoproliferative disorder in adult liver transplant recipients: a report of seventeen cases.
  • Posttransplant lymphoproliferative disorder (PTLD) is a major complication of liver transplantation, but previous descriptions have been limited to case reports and small case series.
  • We report a retrospective analysis of 17 consecutive cases of PTLD associated with liver transplantation.
  • The median age at PTLD diagnosis was 47 years (range 19 - 63) with a median time of 25 months from liver transplantation to PTLD diagnosis (range 3 - 75).
  • PTLD location was frequently extranodal (71%) and involved the transplanted liver (41%).
  • PTLD histology consisted of nine (53%) monomorphic and eight (47%) polymorphic disease.
  • Initial therapy included reduction in immunosuppression (RI) alone in 13 (76%) of 17 patients, resulting in 6 (46%) complete responses (CR) and 7 (54%) progressive disease (PD).
  • Monoclonal CD20 antibody (rituximab) and CHOP chemotherapy were used as initial therapy or as second line after RI failure.
  • Although detection and treatment of PTLD in liver transplant recipients remains problematic and upfront mortality is still high, long-term survival is possible.
  • Further studies are necessary to better define treatment strategies.
  • [MeSH-major] Liver Transplantation / adverse effects. Lymphoproliferative Disorders / diagnosis. Lymphoproliferative Disorders / etiology
  • [MeSH-minor] Adult. Antibodies, Monoclonal / therapeutic use. Antibodies, Monoclonal, Murine-Derived. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Cyclophosphamide / therapeutic use. Disease Progression. Doxorubicin / therapeutic use. Female. Humans. Immunosuppressive Agents / therapeutic use. In Situ Hybridization. Male. Middle Aged. Postoperative Complications. Prednisolone / therapeutic use. Recurrence. Rituximab. Treatment Outcome. Vincristine / therapeutic use

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  • (PMID = 17487731.001).
  • [ISSN] 1042-8194
  • [Journal-full-title] Leukemia & lymphoma
  • [ISO-abbreviation] Leuk. Lymphoma
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antibodies, Monoclonal; 0 / Antibodies, Monoclonal, Murine-Derived; 0 / Immunosuppressive Agents; 4F4X42SYQ6 / Rituximab; 5J49Q6B70F / Vincristine; 80168379AG / Doxorubicin; 8N3DW7272P / Cyclophosphamide; 9PHQ9Y1OLM / Prednisolone; VAP-cyclo protocol
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28. 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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29. 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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  • [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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30. 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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31. 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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32. Licht C, Hell K, Eifinger F, Hoppe B, Querfeld U: Posttransplant lymphoproliferative disease in a child: clinical and molecular characterization. Pediatr Nephrol; 2002 Feb;17(2):79-84
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  • [Title] Posttransplant lymphoproliferative disease in a child: clinical and molecular characterization.
  • Immunosuppressive therapy included cyclosporine A, mycophenolate mofetil and methylprednisolone.
  • The patient developed spiking fever up to 40 degrees C without signs of infection 10 months after TX.
  • Epstein-Barr virus (EBV) polymerase chain reaction (PCR) results with a high number of copies (20 x 10(6) copies/ml blood) against the background of a previous EBV infection (IgG positive, IgM negative) made the diagnosis of EBV-reactivation likely.
  • Examination of the spleen showed EBV-associated polymorphic posttransplant lymphoproliferative disease (PTLD) with predominant B cell proliferation and monoclonal VH3-rearrangement of the IgG heavy chain locus.
  • Therapy with acyclovir was introduced and immunosuppression was reduced.
  • [MeSH-major] Kidney Transplantation / adverse effects. Lymphoproliferative Disorders / etiology
  • [MeSH-minor] Acyclovir / therapeutic use. Antiviral Agents / therapeutic use. Child. Epstein-Barr Virus Infections / drug therapy. Epstein-Barr Virus Infections / etiology. Female. Humans. Immunosuppression / adverse effects. Tomography, X-Ray Computed

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  • (PMID = 11875668.001).
  • [ISSN] 0931-041X
  • [Journal-full-title] Pediatric nephrology (Berlin, Germany)
  • [ISO-abbreviation] Pediatr. Nephrol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Antiviral Agents; X4HES1O11F / Acyclovir
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33. Savoldo B, Rooney CM, Quiros-Tejeira RE, Caldwell Y, Wagner HJ, Lee T, Finegold MJ, Dotti G, Heslop HE, Goss JA: Cellular immunity to Epstein-Barr virus in liver transplant recipients treated with rituximab for post-transplant lymphoproliferative disease. Am J Transplant; 2005 Mar;5(3):566-72
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  • [Title] Cellular immunity to Epstein-Barr virus in liver transplant recipients treated with rituximab for post-transplant lymphoproliferative disease.
  • The evaluation of long-term cellular immunity to EBV in pediatric orthotopic liver transplant (OLT) recipients after treatment with the humanized anti-CD20 monoclonal antibody (Rituximab) has not yet been explored.
  • At our institution, one child with EBV-related mononucleosis-like syndrome and five children with polymorphic-EBV-PTLD occurring 6-88 months after OLT were treated with Rituximab.
  • Treatment was well tolerated.
  • After Rituximab, B-lymphocytes were undetectable in the peripheral blood and EBV-load, monitored with real-time PCR, decreased to undetectable levels in all children from >4000 copies/microg DNA at diagnosis.
  • Four to eight months after Rituximab, EBV-load increased (>4000 copies/microg DNA) in four children, and PTLD recurred in three.
  • Their frequency of EBV-specific T-cell precursors, measured by Elispot analysis, remained lower than in healthy controls.
  • Rituximab effectively induced regression of PTLD in OLT recipients.
  • However, EBV-specific T-cell immunocompetence, which may be crucial for the long-term control of EBV-mediated proliferation, did not improve.
  • [MeSH-major] Antibodies, Monoclonal / pharmacology. Antineoplastic Agents / pharmacology. Epstein-Barr Virus Infections / immunology. Herpesvirus 4, Human / immunology. Lymphoproliferative Disorders / drug therapy
  • [MeSH-minor] Antibodies, Monoclonal, Murine-Derived. Child. Child, Preschool. DNA, Viral / metabolism. Female. Humans. Immunity, Cellular / drug effects. Liver Transplantation. Male. Rituximab. Time Factors

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  • (PMID = 15707412.001).
  • [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
  • [Grant] United States / NIDDK NIH HHS / DK / DK062329; United States / NCI NIH HHS / CA / P01 CA94237; United States / NCRR NIH HHS / RR / RR00188
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] Denmark
  • [Chemical-registry-number] 0 / Antibodies, Monoclonal; 0 / Antibodies, Monoclonal, Murine-Derived; 0 / Antineoplastic Agents; 0 / DNA, Viral; 4F4X42SYQ6 / Rituximab
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34. 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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35. Muti G, Cantoni S, Oreste P, Klersy C, Gini G, Rossi V, D'Avanzo G, Comoli P, Baldanti F, Montillo M, Nosari A, Morra E, Cooperative Study Group on PTLDs: Post-transplant lymphoproliferative disorders: improved outcome after clinico-pathologically tailored treatment. Haematologica; 2002 Jan;87(1):67-77
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  • [Title] Post-transplant lymphoproliferative disorders: improved outcome after clinico-pathologically tailored treatment.
  • BACKGROUND AND OBJECTIVES: Clinical and pathologic variability of post-transplant lymphoproliferative disorders (PTLDs), their aggressive behavior and the recognized therapy-related toxicity make management of patients with these disorders difficult.
  • Assessment of first-line treatment and identification of prognostic factors need to be better defined.
  • DESIGN AND METHODS: Data on 40 PTLDs which developed in adult solid organ recipients were analyzed in order to evaluate clinical and pathologic features, response to treatment and prognostic factors.
  • RESULTS: The median time from transplant to PTLD was 56 months.
  • Regarding histologic features, plasmacytic hyperplasia was diagnosed in 5 patients (12.5%), polymorphic lymphoproliferative disorders in 3 (7.5%), malignant lymphoma in 32 (80%).
  • Late-onset PTLDs (>12 months from transplant) occurred in 33 patients (83%), EBV-negative forms in 12 (31%).
  • Twenty-nine patients completed their scheduled treatment and are evaluable for outcome.
  • The cumulative probability of survival at 1 year is 57% (CI 37.6-73.4) and the median survival time of the entire group has not been reached at 54 months.
  • The International Prognostic Index and the PTLD index are able to identify different risk groups.
  • Therapy tailored on histologic and clinical features of PTLD is feasible and is able to give long-lasting complete responses.
  • [MeSH-major] Epstein-Barr Virus Infections / complications. Immunosuppression / adverse effects. Lymphoproliferative Disorders / etiology. Postoperative Complications / etiology. Transplantation / adverse effects
  • [MeSH-minor] Adult. Aged. Anti-Bacterial Agents / therapeutic use. Antibodies, Monoclonal / therapeutic use. Antibodies, Monoclonal, Murine-Derived. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Antiviral Agents / therapeutic use. Female. Heart Transplantation / adverse effects. Helicobacter Infections / complications. Helicobacter Infections / drug therapy. Helicobacter pylori / isolation & purification. Herpesvirus 4, Human / isolation & purification. Humans. Immunocompromised Host. Interleukin-10 / blood. Kidney Transplantation / adverse effects. Life Tables. Liver Transplantation / adverse effects. Lung Transplantation / adverse effects. Male. Middle Aged. Prognosis. Proportional Hazards Models. Remission Induction. Retrospective Studies. Risk Factors. Rituximab. Survival Analysis. Survival Rate. Time Factors. Treatment Outcome. Viral Load

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  • (PMID = 11801467.001).
  • [ISSN] 0390-6078
  • [Journal-full-title] Haematologica
  • [ISO-abbreviation] Haematologica
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Italy
  • [Chemical-registry-number] 0 / Anti-Bacterial Agents; 0 / Antibodies, Monoclonal; 0 / Antibodies, Monoclonal, Murine-Derived; 0 / Antiviral Agents; 130068-27-8 / Interleukin-10; 4F4X42SYQ6 / Rituximab
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36. 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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37. 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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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [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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