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Pediatric Nephrology

, Volume 19, Issue 4, pp 369–377 | Cite as

The post-transplant lymphoproliferative disorder—a literature review

  • Rokshana Shroff
  • Lesley Rees
Review

Abstract

The Epstein-Barr virus (EBV)-induced post-transplant lymphoproliferative disorder (PTLD) affects 1%–10% of all paediatric renal transplant recipients. This is a heterogeneous group of conditions characterised by EBV-driven proliferation of B-lymphocytes in the face of impaired T-cell immune surveillance. The risk factors predisposing to PTLD are becoming better understood, but its pathogenesis and myriad of clinical and histological features remain poorly defined. While new treatment modalities are being tried with variable success, regular EBV surveillance and carefully monitored reduction of immunosuppression remain the mainstay of treatment. In this review, we have presented the current knowledge of this increasingly common complication in renal transplant recipients.

Keywords

Post-transplant lymphoproliferative disorder Epstein-Barr virus 

References

  1. 1.
    Nalesnik M, Demetris AJ, Fung JJ, Randhawa P, Zeevi A (2000) Post-transplantation lymphoproliferative disorder. Available on Transplantation Clinical Management athttp://www.medscape.com
  2. 2.
    Dharnidharka VR, Sullivan EK, Stablein DM, Tejani AH, Harmon WE (2001) Risk factors for post transplant lymphoproliferative disorder (PTLD) in kidney transplantation: a report of the North American Pediatric Renal Transplant Cooperative Study (NAPRTCS). Transplantation 71:1065–1068PubMedGoogle Scholar
  3. 3.
    Funch DP, Brady J, Ko HH, Dreyer NA, Walker AM (2002) Methods and objectives of a large US multicentre case control study of post-transplant lymphoproliferative disorder in renal transplant patients. Recent Results Cancer Res 159:81–88PubMedGoogle Scholar
  4. 4.
    Pinkerton CR, Hann I, Weston CL, Mapp T, Wotherspoon A, Hobson R, Kelley DA, Vergani D, Hadzic D, Rees L, Burke M, Thomas JA (2002) Immunodeficiency-related lymphoproliferative disorders: prospective data from the United Kingdom Children’s Cancer Study Group. Br J Hematol 118:456–461CrossRefGoogle Scholar
  5. 5.
    Penn I (1998) De novo malignancies in pediatric organ transplant recipients. Pediatr Transplant 2:56–63PubMedGoogle Scholar
  6. 6.
    Shapiro R, Nalesnik M, McCauley J, Fedorek S, Jordan ML, Scantelbury VP, Jain A, Vivas C, Ellis D, Lombardozzi-Lane S, Randhawa P, Johnston J, Hakala TR, Simmons RL, Fung JJ, Starzl TE (1999) Posttransplant lymphoproliferative disorders in adult and pediatric renal transplant recipients receiving tacrolimus based immunosuppression. Transplantation 68:1851–1854PubMedGoogle Scholar
  7. 7.
    Frizzera G (1992) Atypical lymphoproliferative disorders. In: Knowles DM (ed) Neoplastic hematopathology. Williams and Wilkins, Baltimore, pp 459–461Google Scholar
  8. 8.
    Reyes J, Green M, Bueno J (1996) Epstein Barr virus associated posttransplant lymphoproliferative disease after intestinal transplantation. Transplant Proc 28:2768PubMedGoogle Scholar
  9. 9.
    Chen JM, Barr ML, Chadburn A (1998) Management of lymphoproliferative disorders after cardiac transplantation. Ann Thorac Surg 56:527–531Google Scholar
  10. 10.
    Boyle GJ, Michaels MG, Webber SA, Knisely AS, Kurland G, Cipriani LA, Griffith BP, Fricker FJ (1997) Post-transplant lymphoproliferative disorders in paediatric thoracic organ recipients. J Pediatr 131:309–313PubMedGoogle Scholar
  11. 11.
    Raymond E, Tricottet V, Samuel D, Reynes M, Bismuth H, Misset JL (1999) Epstein Barr virus related hepatic lymphoproliferative disorder after liver transplantation. Cancer 76:1344–1349Google Scholar
  12. 12.
    Paya CV, Fung JJ, Nalesnik MA, Kieff E, Green M, Gores G, Habermenn TM, Wiesner RH, Swinnen LJ, Woodle ES, Bromberg JS (1999) Epstein Barr virus induced posttransplant lymphoproliferative disorders. Transplantation 68:1517–1525PubMedGoogle Scholar
  13. 13.
    Ho M, Jaffe R, Miller G (1988) The frequency of Epstein Barr virus infection and associated lymphoproliferative disease after transplantation and its manifestations in children. Transplantation 45:719–724PubMedGoogle Scholar
  14. 14.
    Basgoz N, Preiksatitis JK (1995) Post-transplant lymphoproliferative disorder. Infect Dis Clin North Am 9:901–923PubMedGoogle Scholar
  15. 15.
    Herzig KA, Juffs HG, Norris D, Brown AM, Gill D, Hawley CM, Cobcroft R, Petrie JB, Marlton P, Thompson D, Campbell SB, Nicol DL, Johnson DW (2003) A single-centre experience of post-transplant lymphoproliferative disorder. Transpl Int 16:529–536CrossRefPubMedGoogle Scholar
  16. 16.
    Shroff R, Trompeter R, Cubitt D, Thaker U, Rees L (2002) Epstein Barr virus monitoring in paediatric renal transplant recipients. Paediatr Nephrol 17:770–775CrossRefGoogle Scholar
  17. 17.
    Boubenider S, Hiesse C, Goupy C, Kriaa F, Marchand S, Charpentier B (1997) Incidence and consequences of post-transplantation lymphoproliferative disorders. J Nephrol 10:136–145PubMedGoogle Scholar
  18. 18.
    Sokal EM (1997) Early signs and risk factors for the increased incidence of Epstein Barr virus related post-transplant lymphoproliferative disease in paediatric transplant patients treated with tacrolimus. Transplantation 64:1438–1442PubMedGoogle Scholar
  19. 19.
    Haque T, Thomas JA, Falk KI, Parratt R, Hunt BJ, Yacoub M, Crawford DH (1996) Transfer of donor EBV in transplanted organs causes lymphoproliferative disease in EBV-seronegative recipients. J Gen Virol 77:1169–1172PubMedGoogle Scholar
  20. 20.
    Harwood JS, Gould FK, McMaster A (1999) Significance of Epstein Barr virus status and post-transplant lymphoproliferative disease in paediatric thoracic transplantation. Pediatr Transplant 3:100–105CrossRefPubMedGoogle Scholar
  21. 21.
    Shaninian VB, Muirhead N, Jevnikar AM, Leckie SH, Kharkar A, Luke PP, Rizkalla KS, Hollomby DJ, House AA (2003) Epstein Barr virus seronegativity is a risk factor for late onset posttransplant lymphoproliferative disorder in adult renal allograft recipients. Transplantation 75:851–856CrossRefPubMedGoogle Scholar
  22. 22.
    Libertiny G, Watson CJ, Gray DW, Welsh KI, Morris PJ (2001) Rising incidence of post-transplant lymphoproliferative disease in kidney transplant recipients. Br J Surg 88:1330–1334CrossRefPubMedGoogle Scholar
  23. 23.
    Walker RC, Marshall WF, Strickler JC, Wiesner RH, Velosa JA, Habermann TM, McGregor CG, Paya CV (1995) Pretransplantation assessment of the risk of lymphoproliferative disorder. Clin Infect Dis 20:1346–1353PubMedGoogle Scholar
  24. 24.
    Ellis D, Jaffe R, Green M, Janosky JJ, Lombardozzi-Lane S, Shapiro R, Scantelbury V, Vivas C, Jordan M (1999) Epstein-Barr virus related disorders in children undergoing renal transplantation with tacrolimus based immunosuppression. Transplantation 68:997–1003PubMedGoogle Scholar
  25. 25.
    Starzl TE, Nalesnik MA, Porter KA (1984) Reversibility of lymphomas and lymphoproliferative lesions developing under cyclosporin-steroid therapy. Lancet I:583–587CrossRefGoogle Scholar
  26. 26.
    Cockfield SM (2001) Identifying the patient at risk for post-transplant lymphoproliferative disorder. Transpl Infect Dis 3:70–78CrossRefPubMedGoogle Scholar
  27. 27.
    Nalesnik MA, Jaffe R, Starlz TE, Demetris AJ, Porter K, Burnham JA, Makowka L, Ho M, Locker J (1988) The pathology of posttransplant lymphoproliferative disorders occurring in the setting of cyclosporin A—prednisone immunosuppression. Am J Pathol 133:173–192PubMedGoogle Scholar
  28. 28.
    Dharnidharkar VR, Ho Pl, Stablein DM, Harmon WE, Tejani AH (2002) Mycophenolate, tacrolimus and post-transplant lymphoproliferative disorder: a report of the North American Paediatric Renal Transplant Cooperative Study. Pediatr Transplant 5:396–399CrossRefGoogle Scholar
  29. 29.
    Shpilberg O, Wilson J, Whiteside TL (1999) Pre-transplant immunological profile and risk factor analysis of post-transplant lymphoproliferative disease development: the results of a nested matched case-control study: The University of Pittsburg PTLD study Group. Leuk Lymphoma 36:109–113PubMedGoogle Scholar
  30. 30.
    Shapiro R, Scantelbury VP, Jordan ML, Vivas C, Ellis D, Lombardozzi-Lane S, Gilboa N, Gritsch HA, Irish W, McCauley J, Fung JJ, Hakala TR, Simmons RL, Starlz TE (1999) Pediatric renal transplantation under tacrolimus based immunosuppression 67:299–303Google Scholar
  31. 31.
    Newell KA, Alonso EM, Kelly SM (1999) Association between liver transplantation for Langerhans cell histiocytosis, rejection and development of post-transplant lymphoproliferative disease in children. J Pediatr 131:98–103Google Scholar
  32. 32.
    Manez R, Breinig MC, Linden P, Wilson J, Torre-Cisneros J, Kusne S, Dummer S, Ho M (1997) Post-transplant lymphoproliferative disease in primary Epstein Barr virus infection after liver transplantation: the role of cytomegalovirus disease. J Infect Dis 176:1462–1467PubMedGoogle Scholar
  33. 33.
    Buda A, Caforio A, Calabrese F, Fagiuoli S, Pevere S, Livi U, Naccarato R, Burra P (2000) Lymphoproliferative disorders in heart transplant recipients: the role of hepatitis C virus and Epstein Barr virus infection. Transpl Int 13:S402–S405CrossRefPubMedGoogle Scholar
  34. 34.
    Epstein MA, Achong BG, Barr YM (1964) Virus particles in cultured lymphoblasts from Burkitt lymphoma. Lancet I:702–713CrossRefGoogle Scholar
  35. 35.
    Zaia JA (1998) Infections in organ transplant recipients. In: Clinical Virology. Churchill LivingstoneGoogle Scholar
  36. 36.
    Henle G, Henle W (1979) Seroepidemiology of the virus. In: Epstein MA, Achong BG (eds) The Epstein-Barr virus. Springer-Verlag, Berlin Heidelberg New York, pp 297–310Google Scholar
  37. 37.
    Ppe JH, Horne MK, Scott W (1968) Transformation of human leucocytes in vitro by infiltrates of a human leukaemia cell line containing herpes-like virus. Int J Cancer 3:857–861PubMedGoogle Scholar
  38. 38.
    Sixbey JW, Nedrud JG, Raab-Traub N, Hanes RA, Pagano JS (1984) Epstein Barr virus replication in oropharyngeal epithelial cells. N Engl J Med 310:1225–1228PubMedGoogle Scholar
  39. 39.
    Miyashita EM, Yang B, Lam KMC, Crawford DH, Thorley-Lawson DA (1995) A novel form of Epstein Barr viral latency in normal B cells. Cell 80:593–599PubMedGoogle Scholar
  40. 40.
    Moss DJ, Wallace LE, Rickinson AB, Epstein MA (1989) Cytotoxic T-cell recognition of Epstein Barr virus infected B-cells: HLA restriction of effector cells reactivated in vitro. Eur J Immunol 11:686–690Google Scholar
  41. 41.
    Hsieh WS, Lemas MV, Ambinder RF (1999) The biology of Epstein-Barr virus in post-transplant lymphoproliferative disease. Transpl Infect Dis 1:204–212CrossRefPubMedGoogle Scholar
  42. 42.
    Tanner JE, Alfieri C (2001) The Epstein-Barr virus and post-transplant lymphoproliferative disease: interplay of immunosuppression, EBV and the immune system in disease pathogenesis. Transpl Infect Dis 3:60–69CrossRefPubMedGoogle Scholar
  43. 43.
    Swinnen LJ, Costanzo-Nordin MR, Fischer SG (1990) Increased incidence of lymphoproliferative disorder after immunosuppression with the monoclonal antibody OKT3 in cardiac transplant recipients. N Engl J Med 323:1723–1727PubMedGoogle Scholar
  44. 44.
    Ho M, Breinig MK, Drummer JS (1985) Epstein Barr virus infections and DNA hybridisation studies in post-transplantation lymphomas and lymphoproliferative lesions: the role of primary infections. J Infect Dis 152:876–881PubMedGoogle Scholar
  45. 45.
    Holmes RD, Sokol RJ (2002) Epstein Barr virus and post-transplant lymphoproliferative disease. Pediatr Transplant 6:456–464CrossRefPubMedGoogle Scholar
  46. 46.
    Ho M (1995) Risk factors and pathogenesis of post-transplant lymphoproliferative disorders. Transplant Proc 27 [Suppl 1]:38–40Google Scholar
  47. 47.
    Collins MH, Montone KT, Leahey AM, Hodinka RL, Salhany KE, Belchis DA, Tomaszewski JE (2001) Autopsy pathology of pediatric post-transplant lymphoproliferative disorder. Pediatrics 107:E89PubMedGoogle Scholar
  48. 48.
    Srivastava T, Zwick DL, Rothberg PG, Warady BA (1999) Post-transplant lymphoproliferative disorder in pediatric renal transplantation. Pediatr Nephrol 13:748–754PubMedGoogle Scholar
  49. 49.
    Rees L, Thomas A, Amlot PL (1998) Disappearance of an Epstein-Barr virus-positive post-transplant plasmacytoma with reduction of immunosuppression. Lancet 352:789Google Scholar
  50. 50.
    Darenkov IA, Marcarelli MA, Basadonna GP, Friedman AL, Lorber KM, Howe JG, Crouch J, Bia MJ, Kliger AS, Lorber MI (1997) Reduced incidence of Epstein-Barr virus associated post-transplant lymphoproliferative disorder using preemptive antiviral therapy. Transplantation 64:848–852PubMedGoogle Scholar
  51. 51.
    Davis CL, Harrison KL, McVicar JP, Forg PJ, Bronner MP, Marsh CL (1995) Antiviral prophylaxis and the Epstein Barr virus related post-transplant lymphoproliferative disorder. Clin Transplant 9:53–59PubMedGoogle Scholar
  52. 52.
    Dotti G, Fiocchi R, Motta T, Gamba A, Gotti E, Gridelli B, Borle-Manzoni C, Viero P, Remuzzi G, Barbui T, Rambaldi A (2000) Epstein-Barr virus negative lymphoproliferative disorder in long-term survivors after heart, kidney and liver transplant. Transplantation 69:705–706PubMedGoogle Scholar
  53. 53.
    Sivaraman P, Lye WC (2001) Epstein-Barr virus associated T-cell lymphomas in solid organ transplant recipients. Biomed Pharmacother 55:366–368CrossRefPubMedGoogle Scholar
  54. 54.
    Ambinder RF (2000) Gammaherpes viruses and “hit-and-run” oncogenesis. Am J Pathol 156:127–131Google Scholar
  55. 55.
    Dockrell DH, Strickler JG, Paya CV (1998) Epstein Barr virus induced T-cell lymphomas in solid organ transplant recipients. Clin Infect Dis 26:180–184PubMedGoogle Scholar
  56. 56.
    Nalesnik MA (2002) Clinicopathological characteristics of post-transplant lymphoproliferative disorder. Recent Results Cancer Res 159:9–18PubMedGoogle Scholar
  57. 57.
    Lippman SM, Grogan TM, Carry P (1987) Post-transplantation T cell lymphoblastic lymphoma. Am J Med 82:814–818PubMedGoogle Scholar
  58. 58.
    Schwab M, Boswald M, Korn K, Rudder H (2000) Epstein-Barr virus in pediatric patients after renal transplantation. Clin Nephrol 53:132–139PubMedGoogle Scholar
  59. 59.
    Collins MH, Montone KT, Leahey AM, Hodinka RL, Salhany KE, Kramer DL, Deng C, Tomaszewski JE (2001) Posttransplant lymphoproliferative disease in children. Pediatr Transplant 5:2CrossRefGoogle Scholar
  60. 60.
    Shapiro NL, Strocker AM (2001) Adenotonsillar hypertrophy and Epstein Barr virus in pediatric organ transplant recipients. Laryngoscope 111:997–1001PubMedGoogle Scholar
  61. 61.
    Martinez AJ, Ahbad-Barmada M (1993) The neuropathology of liver transplantation: comparison of complications in children and adults. Mod Pathol 6:25–29PubMedGoogle Scholar
  62. 62.
    Cohen JI (1991) Epstein Barr virus lymphoproliferative disease associated with acquired immunodeficiency. Medicine (Baltimore) 70:137–141Google Scholar
  63. 63.
    Preiksaitis JK, Diaz-Mitoma F, Miryazan F, Roberts S, Tyrell A (1992) Quantitative oropharyngeal Epstein-Barr virus shedding in renal and cardiac transplant recipients: relationship to immunosuppressive therapy, serological responses and the risk of post-transplant lymphoproliferative disorder J Infect Dis 166:986–994Google Scholar
  64. 64.
    Hanasono MM, Kamel OW, Chang PP (1995) Detection of Epstein Barr virus in cardiac biopsies of heart transplant patients with lymphoproliferative disorder. Transplantation 60:471–476PubMedGoogle Scholar
  65. 65.
    Mihalov ML, Gattuso P, Abraham K (1996) Incidence of post-transplant malignancy amongst 674 solid organ transplant recipients at a single centre. Clin Transpl 10:248–255PubMedGoogle Scholar
  66. 66.
    Campe H, Jaeger G, Abou-Ajram C, Nitschko H, Griebel M, Montoya C, Klare B, Koszinowski U (2003) Serial detection of Epstein Barr DNA in sera and peripheral blood leucocyte samples of pediatric renal allograft recipients with persistent mononucleosis-like symptoms defines patients at risk of developing post-transplant lymphoproliferative disease. Pediatr Transplant 7:46–52CrossRefPubMedGoogle Scholar
  67. 67.
    Leung E, Shenton BK, Jackson G, Gould FK, Yap C, Talbot D (2002) Use of real-time PCR to measure Epstein-Barr virus genomes in whole blood. J Immunol Methods 270:259–267PubMedGoogle Scholar
  68. 68.
    Meerbach A, Gruhn B, Egerer R, Reischl U, Zintl F, Wutzler P (2001) Semiquantitative PCR analysis of Epstein Barr virus DNA in clinical samples of patients with EBV-associated diseases. J Med Virol 65:348–357CrossRefPubMedGoogle Scholar
  69. 69.
    Haque T, Thomas A, Parratt R, Hunt BJ, Yacoub MH, Crawford DH (1997) A prospective study in heart and lung transplant recipients correlating persistent Epstein-Barr virus infection with clinical events. Transplantation 64:1028–1034PubMedGoogle Scholar
  70. 70.
    Gartner BC, Fischinger J, Schafer H, Einsele H, Roemer K, Lantzsch N (2002) Epstein-Barr viral load as a tool to diagnose and monitor post-transplant lymphoproliferative disease. Recent Results Cancer Res 159:49–54PubMedGoogle Scholar
  71. 71.
    Stevens SJ, Verschuuren EA, Pronk I, Der Bij W van, Harmsenne MC, The TH, Meijer CJ, Den Brule AJ van, Middeldorp JM (2001) Frequent monitoring of Epstein-Barr virus load in unfractionated whole blood is essential for early detection of post-transplant lymphoproliferative disease in high-risk patients. Blood 97:1165–1171CrossRefPubMedGoogle Scholar
  72. 72.
    Rowe DT, Reyes LQUJ, Jabbour N (1997) Use of quantitative PCR to measure Epstein-Barr virus genome load in the peripheral blood of paediatric transplant patients with lymphoproliferative disorders. J Microbiol 35:1612–1617Google Scholar
  73. 73.
    Zingg W, Bossart W, Berli E, Nadal D (1999) Detection and quantification of cell free Epstein-Barr virus by polymerase chain reaction and subsequent DNA enzyme immunoassay. J Virol Methods 79:141–148PubMedGoogle Scholar
  74. 74.
    Merlino C, Cavallo R, Bergallo M, Giorgi S, Forgnone F, Re D, Sinesi F, Musso T, Negro Ponzi A (2001) Quantitative PCR in EBV-infected renal transplant patients. New Microbiol 24:223–229PubMedGoogle Scholar
  75. 75.
    Rowe M, Lear A, Croom-Carter D (1992) Three pathways of Epstein-Barr gene activation from EBNA-positive latency in B lymphocytes. J Virol 66:122–127PubMedGoogle Scholar
  76. 76.
    Kieff E (1996) Epstein Barr virus and its replication. In: Fields BN, Knipe DM, Howley PM (eds) Fields virology, vol 3. Lippincott-Raven, Philadelphia, pp 2343–2349Google Scholar
  77. 77.
    Darenkov A, Marcarelli MA, Basadonna GP (1997) Reduced incidence of post-transplant lymphoproliferative disease using pre-emptive anti-viral therapy. Transplantation 64:848–852PubMedGoogle Scholar
  78. 78.
    Bokenkamp A, Grabensee A, Stoffel-Wagner B, Hasan C, Offner G, Lentze MJ (2002) The beta2-microglobulin/ cystatin C ratio—a potential marker of post-transplant lymphoproliferative disease. Clin Nephrol 58:417–422PubMedGoogle Scholar
  79. 79.
    Expert Group on Renal Transplantation (2002) European best practice guidelines for renal transplantation. IV. Long-term management of transplant recipients. IV.6.1. Cancer risk after renal transplantation: posttransplant lymphoproliferative disorder—prevention and management. Nephrol Dial Transplant 17 [Suppl 4]:31–36Google Scholar
  80. 80.
    Newell KA, Alonso EM, Whitington PF, Bruce DS, Millis JM, Pi JB, Woodle ES, Kelly SM, Koeppen H, Hart J, Rubin CM, Thistlethwaite JR Jr (1996) Posttransplant lymphoproliferative disease in pediatric liver transplantation: interplay between primary Epstein Barr virus infection and immunosuppression. Transplantation 62:370–375PubMedGoogle Scholar
  81. 81.
    Morgan AJ, Finerty S, Lovgren K, Scullion FT, Morein B (1988) Recombinant vaccinia virus expressing Epstein Barr virus glycoprotein incorporated into immune-stimulating complexes. J Gen Virol 8:2093–2096Google Scholar
  82. 82.
    Gu SY (1995) First EBV vaccine trial in humans using recombinant vaccinia virus expressing the major membrane antigen. Dev Biol Stand 84:171–177PubMedGoogle Scholar
  83. 83.
    Andersson J, Skoldenberg B, Enrberg I, Britton S, Henle W, Andersson U (1985) Aciclovir treatment in primary Epstein Barr virus infection—a double blind placebo controlled study. Scand J Infect Dis 47:107–111Google Scholar
  84. 84.
    Yao QY, Ogan R, Rowe M, Wood M, Rickinson AB (1989) Epstein Barr virus infected B-cells persist in the circulation of aciclovir treated virus carriers. Int J Cancer 43:67–72PubMedGoogle Scholar
  85. 85.
    Starzl TE, Porter KA, Iwatsuki S (1998) Reversibility of lymphomas and lymphoproliferative lesions developing under cyclosporin-steroid therapy. Lancet I:583–587Google Scholar
  86. 86.
    Haque T, Amlot PL, Helling N, Thomas JA, Sweny P, Rolles K, Burroughs AK, Prentice HG, Crawford DH (1998) Reconstitution of EBV specific T-cell immunity in solid organ transplant recipients. J Immunol 160:6204–6209PubMedGoogle Scholar
  87. 87.
    Amlot PL (1998) Management of post transplant lymphoproliferative disorder (PTLD). Pediatr Nephrol 12:02SCrossRefGoogle Scholar
  88. 88.
    Porcu P, Eisenbeis CF, Pelletier RP, Davies EA, Baiocchi RA, Roychowdhury S, Vourganti S, Nuovo GJ, Marsh WL, Ferketic AK, Henry ML, Ferguson RM, Caligiuri MA (2002) Successful treatment of post-transplantation lymphoproliferative disorder following renal allografting is associated with sustained CD8+ T-cell restoration. Blood 100:2341–2348CrossRefPubMedGoogle Scholar
  89. 89.
    Benkerrou M, Jais JP, Leblond V (1998) Anti-B cell monoclonal antibody treatment of severe post-transplant lymphoproliferative disorder: prognosis factors and long-term outcome. Blood 92:3137–3141PubMedGoogle Scholar
  90. 90.
    Benkerrou M, Durandy A, Fischer A (1993) Therapy for transplant related lymphoproliferative disease. Hematol Oncol Clin North Am 7:467–471PubMedGoogle Scholar
  91. 91.
    Cook RC, Connors JM, Gascoyne RD, Fradet G, Levy RD (1999) Treatment of post-transplant lymphoproliferative disease with Rituximab monoclonal antibody after lung transplantation. Lancet 354:1698–1699PubMedGoogle Scholar
  92. 92.
    Faro A (1988) Interferon alfa and its effects on post-transplant lymphoproliferative disorders. Springer Semin Immunopathol 20:425CrossRefGoogle Scholar
  93. 93.
    Swinnen LJ, Mullen GM, Carr TJ, Costanzo MR, Fisher RI (1995) Aggressive treatment for post-transplant lymphoproliferation. Blood 86:3333–3337PubMedGoogle Scholar
  94. 94.
    Papadopoulos EB, Ladany M, Emanuel D (1994) Infusion of donor leucocytes to treat Epstein Barr virus associated lymphoproliferative disorders after allogenic bone marrow transplant. N Engl J Med 330:1185–1190Google Scholar
  95. 95.
    Rooney CM, Smith CA, Ng CYC (1995) Infusion of cytotoxic T lymphocytes for the prevention of Epstein Barr induced lymphoma in allogenic transplant recipients. Blood 92:1549–1552Google Scholar
  96. 96.
    Haque T, Wilkie GM, Taylor C, Amlot PL, Murad P, Iley A, Dombagoda D, Britton KM, Swerdlow AJ, Crawford DH (2002) Treatment of Epstein Barr virus positive post-transplantation lymphoproliferative disease with partly HLA-matched allogenic cytotoxic T-cells. Lancet 360:436–441CrossRefPubMedGoogle Scholar
  97. 97.
    Demircin G, Rees L (1997) Retransplantation after post-transplant lymphoproliferative disease. Pediatr Nephrol 11:358–360PubMedGoogle Scholar
  98. 98.
    Nathanson S, Debray D, Delarue A, Deschenes G (2002) Long-term survival after post-transplant lymphoproliferative disease in children. Pediatr Nephrol 17:668–672CrossRefPubMedGoogle Scholar

Copyright information

© IPNA 2004

Authors and Affiliations

  1. 1.Department of NephrourologyGreat Ormond Street Hospital for ChildrenLondonUK

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