Article
Medicine, General & Internal
Austin Feindt, Montserrat Lara-Velazquez, Ahmad Alkhasawneh, Dinesh Rao, Raafat Makary, Keith Dombrowski, Daryoush Tavanaiepour, Gazanfar Rahmathulla
Summary: This case report presents a 72-year-old female patient who had undergone renal transplant 11 years ago and developed progressively worsening headaches and confusion. Imaging revealed brain edema in the frontal and temporal lobes. Surgical biopsy confirmed a diagnosis of Polymorphic PTLD. Early diagnosis is crucial for patient survival with PTLD.
JOURNAL OF CLINICAL MEDICINE
(2022)
Review
Oncology
Mariam Markouli, Fauzia Ullah, Najiullah Omar, Anna Apostolopoulou, Puneet Dhillon, Panagiotis Diamantopoulos, Joshua Dower, Carmelo Gurnari, Sairah Ahmed, Danai Dima
Summary: PTLD is a severe complication with variable incidence and timing depending on factors related to patients, treatments, and transplants. The pathogenesis is complex, mainly associated with EBV infection and decreased T-cell immune surveillance due to immunosuppression. Treatment is based on histologic subtypes, but specific management guidelines are lacking due to limited clinical trials.
Article
Immunology
Ayantika Sen, Jeanna Enriquez, Mahil Rao, Marla Glass, Yarl Balachandran, Sharjeel Syed, Clare J. Twist, Kenneth Weinberg, Scott D. Boyd, Daniel Bernstein, Amber W. Trickey, Dita Gratzinger, Brent Tan, Mary Gay Lapasaran, Mark A. Robien, Merideth Brown, Brian Armstrong, Dev Desai, George Mazariegos, Clifford Chin, Thomas M. Fishbein, Robert S. Venick, Akin Tekin, Heiner Zimmermann, Ralf U. Trappe, Ioannis Anagnostopoulos, Carlos O. Esquivel, Olivia M. Martinez, Sheri M. Krams
Summary: Post-transplant lymphoproliferative disorder (PTLD) is a serious complication of solid organ transplantation, associated with Epstein-Barr virus (EBV) infection. This study found that miR-194 and several other miRs were significantly decreased in the tumors and circulation of PTLD patients, which may be associated with EBV. These findings suggest the importance of studying the diagnostic and therapeutic potential of miRs in PTLD.
FRONTIERS IN IMMUNOLOGY
(2022)
Review
Oncology
Cecilia Nakid-Cordero, Marine Baron, Amelie Guihot, Vincent Vieillard
Summary: Post-transplant lymphoproliferative disorders (PTLDs) are life-threatening complications after solid organ or hematopoietic stem cell transplants, commonly associated with EBV infection and immunosuppressive therapy. While most PTLD cases are B cell-originated, rare cases involve T cell or NK cell origin. The impaired anti-viral and anti-tumoral immunosurveillance due to long-term immunosuppression is believed to contribute to PTLD pathogenesis, with T cell impairment being critical in EBV-linked complications post-transplantation, while the role of NK cells remains less understood and may vary between EBV-positive and EBV-negative PTLDs.
Review
Pediatrics
Rosanna Fulchiero, Sandra Amaral
Summary: Post-transplant lymphoproliferative disease (PTLD) is a common malignancy that occurs after solid organ transplantation, primarily caused by Epstein-Barr virus infection and immunosuppression. It significantly affects the survival rate and organ function of pediatric kidney transplant recipients.
FRONTIERS IN PEDIATRICS
(2022)
Article
Oncology
Chloe Borde, Frederique Quignon, Corinne Amiel, Joel Gozlan, Vincent Marechal, Eolia Brissot
Summary: A new molecular assay (methyl-qPCR) was designed to distinguish methylated versus unmethylated Epstein-Barr virus (EBV) genomes. This method showed potential for distinguishing latent and lytic EBV genomes in transplant recipients, aiding in treatment decisions.
CLINICAL EPIGENETICS
(2022)
Article
Cardiac & Cardiovascular Systems
Sophie Duignan, Aengus O'Marcaigh, John Russell, Rania Mehanna, Michael McDermott, Matthew Fenton, Colin J. McMahon
Summary: This case describes a rare presentation of post-transplant lymphoproliferative disorder (PTLD) in a 4 year-old boy who had undergone heart transplantation. The PTLD developed in an unusual site, the larynx, and required a novel treatment approach including elective tracheostomy and EBV-specific cytotoxic T lymphocytes (CTL) therapy. The treatment was successful and the patient achieved negative biopsy results, allowing for decannulation and discharge.
JOURNAL OF HEART AND LUNG TRANSPLANTATION
(2022)
Review
Oncology
Eric Lau, Justin Tyler Moyers, Billy Chen Wang, Il Seok Daniel Jeong, Joanne Lee, Lawrence Liu, Matthew Kim, Rafael Villicana, Bobae Kim, Jasmine Mitchell, Muhammed Omair Kamal, Chien-Shing Chen, Yan Liu, Jun Wang, Richard Chinnock, Huynh Cao
Summary: PTLD is a lymphoid or plasmacytic proliferation that develops in immunosuppressed recipients of solid organ transplantation, with infants having a longer time to PTLD diagnosis and EBV viral load potentially serving as a marker of survival in EBV-positive PTLD patients.
Review
Medicine, General & Internal
Tatsuya Okamoto, Hideaki Okajima, Elena Yukie Uebayashi, Eri Ogawa, Yosuke Yamada, Katsutsugu Umeda, Hidefumi Hiramatsu, Etsurou Hatano
Summary: With the advancement of immunosuppressive strategies, liver transplantation outcomes have improved significantly in children. However, Epstein-Barr virus infection and post-transplant lymphoproliferative diseases (PTLD), such as malignant lymphoma, remain serious complications that contribute to morbidity and mortality. Recently, early diagnosis through quantitative PCR and PET-CT testing, as well as treatment with rituximab, have shown promising results in achieving long-term remission. However, determining the optimal immunosuppression protocol after PTLD remission and finding treatments for refractory PTLD (e.g., PTL-NOS) are still areas of focus.
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Surgery
Vibeke K. J. Vergote, Christophe M. Deroose, Steffen Fieuws, Wim Laleman, Ben Sprangers, Anne Uyttebroeck, Johan Van Cleemput, Gregor Verhoef, Robin Vos, Thomas Tousseyn, Daan Dierickx
Summary: This study retrospectively reviewed 196 cases of post-transplant lymphoproliferative disorder (PTLD) after solid organ transplantation and found that EBV status and year of diagnosis may have an impact on patient prognosis.
TRANSPLANT INTERNATIONAL
(2022)
Review
Oncology
Michelle Lee, Aseala Abousaud, R. Andrew Harkins, Ellen Marin, Deepali Balasubramani, Michael C. Churnetski, Deniz Peker, Ankur Singh, Jean L. Koff
Summary: This review examines recent advances in risk assessment, genomic profiling, and trials of PTLD-directed therapy to better understand the state of the science in PTLD. Clinical trials have shown that rituximab-based sequential therapy is a rational treatment strategy for CD20+ PTLD patients who do not respond to reduction of immunosuppression alone. EBV-targeted cytotoxic lymphocytes and CAR-T cell therapy show promise, but further trials are needed to establish their safety and efficacy in PTLD patients.
CURRENT ONCOLOGY REPORTS
(2023)
Review
Infectious Diseases
Julian Lindsay, Jad Othman, Madeleine R. Heldman, Monica A. Slavin
Summary: Management of EBV PTLD involves complex measures such as risk stratification, preemptive therapy, and balancing treatment options. Experimental therapies like donor-derived multipathogen and EBV specific CTLs show promise in prevention and treatment of EBV PTLD.
CURRENT OPINION IN INFECTIOUS DISEASES
(2021)
Article
Clinical Neurology
Daisuke Sato, Hirokazu Takami, Shunsaku Takayanagi, Kazuki Taoka, Mariko Tanaka, Reiko Matsuura, Shota Tanaka, Nobuhito Saito
Summary: This is the first report documenting the development of other iatrogenic immunodeficiency-associated lymphoproliferative disorder (OIIA-LPD) during temozolomide therapy. Timely diagnosis of the disease and discontinuation of temozolomide were considered to be the preferred management. Close monitoring for relapse should be continued.
Article
Pharmacology & Pharmacy
Hao Ji, Taihua Yang, Chunlai Li, Youwei Zhu, Zhigang Zheng, Jiaxu Zhang, Yuan Liu, Yijin Gao, Huimin Wu, Jinxing Jiang, Junekong Yong, Mengke Chen, Yuanjia Tang, Qiang Xia, Feng Xue
Summary: Post-transplant lymphoproliferative disorder (PTLD) is a serious complication after transplantation, with 80% of patients being positive for Epstein-Barr virus (EBV). However, monitoring EBV DNA load for preventing and diagnosing EBV-PTLD has limited accuracy. Therefore, there is an urgent need for new diagnostic molecular markers. This study discovered that BHRF1-1 and BART2-5p, elevated in EBV-PTLD patients, promote proliferation and suppress apoptosis. Mechanistically, they inhibit the tumor suppressor gene LZTS2 and activate the PI3K-AKT pathway. These findings suggest that BHRF1-1 and BART2-5p could serve as potential diagnostic markers and therapeutic targets for EBV-PTLD.
BIOCHEMICAL PHARMACOLOGY
(2023)
Review
Medicine, General & Internal
Michele Clerico, Irene Dogliotti, Andrea Aroldi, Chiara Consoli, Luisa Giaccone, Benedetto Bruno, Federica Cavallo
Summary: Post-transplant lymphoproliferative disease (PTLD) is a serious complication of immunosuppression after allogeneic hematopoietic stem cell transplantation (alloHSCT) or solid organ transplantation (SOT). The majority of PTLD cases are caused by B-cell abnormalities and are associated with Epstein-Barr virus (EBV) infection. The EBV serological status and the degree of T-cell immunosuppression are considered significant risk factors for developing PTLD. Despite advancements in understanding the pathogenesis and introducing new treatment options, treating PTLD after alloHSCT remains challenging, particularly in rituximab-refractory cases. This review focuses on exploring the pathogenesis, risk factors, and treatment options of PTLD in the alloHSCT setting, specifically adoptive immunotherapy options such as EBV-specific cytotoxic T-lymphocytes (EBV-CTL) and chimeric antigen receptor T-cells (CAR T).
JOURNAL OF CLINICAL MEDICINE
(2022)