Post Transplant Lymphoproliferative Disorders
Pathophysiology
Incidence of non-Hodgkin lymphoma in kidney and heart transplant recipients.
Opelz G, Henderson R.
Lancet. 1993;342:1514-1516.
Description: Study documents incidence of PTLD and association between aggressiveness and degree of immunosuppressive regimen.
PubMed citation number: 7902900.
Posttransplant lymphoproliferative disorders in solid organ recipients are predominantly aggressive tumors of host origin.
Weissmann DJ, Ferry JA, Harris NL, Louis DN, Delmonico F, Spiro I.
Am J Clin Path. 1995;103:748-755.
Description: Study identifies origin of majority of cases of PTLD (in solid organ transplantation) is host rather than donor.
PubMed citation number: 7785662
Epstein-Barr virus and a cellular signaling pathway in lymphomas from immunosuppressed patients.
Liebowitz D.
N Engl J Med. 1998;338:1413-1421.
Description: Demonstrates signaling pathways involved in pathogenesis of EBV-positive lymphomas.
PubMed citation number: 9580648
Clinical diagnosis/prognosis
Pretransplantation assessment of the risk of lymphoproliferative disorder.
Walker RC, Marshall WG, Strickler JG, et al.
Clin Infect Dis. 1995;20:1346-1353.
Description: Report of the pretransplantation factors that increase the risk for an individual to develop PTLD. PubMed citation number: 7620022
Identification of prognostic factors in 61 patients with posttransplantation lymphoproliferative disorders.
Leblond V, Dhedin N, Mamzer Bruneel MF, et al.
J Clin Oncol. 2001;19:772-778.
Description: Report of the prognostic factors and long-term outcomes in patients with PTLD.
PubMed citation number: 11157030
Treatment
The pathology of posttransplant lymphoproliferative disorders occurring in the setting of cyclosporine A-prednisone immunosuppression.
Nalesnik MA, Jaffe R, Starzl TE, et al.
Am J Pathol. 1988;133:173-192.
Description: Establishes reduction of immunosuppressive regimen as first-line treatment approach for patients with PTLD.
PubMed citation number: 2845789
Aggressive treatment for postcardiac transplant lymphoproliferation.
Swinnen LJ, Mullen GM, Carr TJ, Costanzo MR, Fisher RI.
Blood. 1995;86:3333-3340.
Description: Demonstrates feasibility of aggressive chemotherapy in patients with PTLD that fails to respond to reduction of immunosuppressive regimen.
PubMed citation number: 7579436
Humanized anti-CD20 monoclonal antibody (Rituximab) in post transplant B-lymphoproliferative disorder: a retrospective analysis on 32 patients.
Milpied N, Vasseur B, Parquet N, et al.
Ann Oncol. 2000;11:113-116.
Description: Report on efficacy of monoclonal antibody based therapy for treatment of PTLD.
PubMed citation number: 10707791.
Epstein-Barr virus (EBV) load in bone marrow transplant recipients at risk to develop posttransplant lymphoproliferative disease: prophylactic infusion of EBV-specific cytotoxic T cells.
Gustafsson A, Levitsky V, Zou JZ, et al.
Blood. 2000;95:807-814.
Description: Establishes the proof of principle that EBV-specific CTL can reduce viral load, and that prophylactic infusions in high-risk individuals may be an effective strategy for preventing PTLD.
PubMed citation number: 10648390
Review
Epstein-Barr virus-induced posttransplant lymphoproliferative disorders: a ASTS/ASTP EBV-PTLD Task Force and the Mayo Clinic Organized International Consensus Development Meeting.
Paya CV, Fung JJ, Nalesnik MA, et al.
Transplantation. 1999;68:1517-1525.
PubMed citation number: 10589949
Post-transplant lymphoproliferative disorder: a review.
Loren AW, Porter DL, Stadtmauer EA, Tsai DE.
Bone Marrow Transplant. 2003;31:145-155.
PubMed citation number: 12621474