Post-transplant lymphoproliferative disorders

• Published in: Annual review of medicine Vol. 56; no. 1; pp. 29 - 44
• Main Authors: Gottschalk, Stephen, Rooney, Cliona M, Heslop, Helen E
• Format: Journal Article
• Language: English
• Published: United States Annual Reviews, Inc 01.01.2005
• Subjects: Dose-Response Relationship, Drug; Hematopoietic Stem Cell Transplantation; Herpesvirus 4, Human - pathogenicity; Humans; Immune system; Immunosuppressive Agents - administration & dosage; Immunosuppressive Agents - adverse effects; Leukemia, B-Cell - etiology; Leukemia, B-Cell - therapy; Lymphoma; Lymphoma, B-Cell - etiology; Lymphoma, B-Cell - therapy; Lymphoproliferative Disorders - diagnosis; Lymphoproliferative Disorders - etiology; Lymphoproliferative Disorders - therapy; Medical disorders; Postoperative Complications - etiology; Prognosis; Risk Factors; Stem cells; Tissue Transplantation; Transplants & implants; Virulence; Viruses
• ISSN: 0066-4219; 1545-326X
• DOI: 10.1146/annurev.med.56.082103.104727

Post-transplant lymphoproliferative disorder (PTLD) is a life-threatening complication after hematopoietic stem cell or solid organ transplantation. The majority of PTLD is of B-cell origin and associated with Epstein-Barr virus (EBV). During the past decade progress has been made in better understanding the pathogenesis of PTLD, and early detection strategies, such as serial measurement of EBV-DNA load in peripheral blood samples, have assisted in the identification of high-risk patients. In addition, novel immunotherapies have been developed, including the use of monoclonal antibodies and adoptive transfer of EBV-specific T cells. Despite these advances, it remains a major challenge to define indications for preemptive therapies for PTLD and to integrate novel therapeutic approaches with conventional therapies.