eMedicine Specialties > Transplantation > Complications
Posttransplant Lymphoproliferative Disease: Multimedia
Updated: Oct 22, 2008
Multimedia
![]() | Media file 2: Biopsy of gingival tissue (400 X). Epstein-Barr virus encoded RNA (EBER) study shows numerous positive cells, which is consistent with posttransplant lymphoproliferative disease (PTLD). |
More on Posttransplant Lymphoproliferative Disease |
| Overview: Posttransplant Lymphoproliferative Disease |
| Differential Diagnoses & Workup: Posttransplant Lymphoproliferative Disease |
| Treatment & Medication: Posttransplant Lymphoproliferative Disease |
| Follow-up: Posttransplant Lymphoproliferative Disease |
Multimedia: Posttransplant Lymphoproliferative Disease |
| References |
| « Previous Page |
References
Shapiro R, Nalesnik M, McCauley J. Posttransplant lymphoproliferative disorders in adult and pediatric renal transplant patients receiving tacrolimus-based immunosuppression. Transplantation. Dec 27 1999;68(12):1851-4. [Medline].
Srivastava T, Zwick DL, Rothberg PG. Posttransplant lymphoproliferative disorder in pediatric renal transplantation. Pediatr Nephrol. Nov 1999;13(9):748-54. [Medline].
Hauke R, Smir B, Greiner T. Clinical and pathological features of posttransplant lymphoproliferative disorders: influence on survival and response to treatment. Ann Oncol. Jun 2001;12(6):831-4. [Medline].
Leblond V, Dhedin N, Mamzer Bruneel MF, et al. Identification of prognostic factors in 61 patients with posttransplantation lymphoproliferative disorders. J Clin Oncol. Feb 1 2001;19(3):772-8. [Medline].
Raut A, Huryn J, Pollack A, Zlotolow I. Unusual gingival presentation of post-transplantation lymphoproliferative disorder: a case report and review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. Oct 2000;90(4):436-41. [Medline].
Cox KL, Lawrence-Miyasaki LS, Garcia-Kennedy R. An increased incidence of Epstein-Barr virus infection and lymphoproliferative disorder in young children on FK506 after liver transplantation. Transplantation. Feb 27 1995;59(4):524-9. [Medline].
Cockfield SM, Preiksaitis JK, Jewell LD, Parfrey NA. Post-transplant lymphoproliferative disorder in renal allograft recipients. Clinical experience and risk factor analysis in a single center. Transplantation. Jul 1993;56(1):88-96. [Medline].
Rooney CM, Loftin SK, Holladay MS. Early identification of Epstein-Barr virus-associated post- transplantation lymphoproliferative disease. Br J Haematol. Jan 1995;89(1):98-103. [Medline].
Knowles DM, Cesarman E, Chadburn A. Correlative morphologic and molecular genetic analysis demonstrates three distinct categories of posttransplantation lymphoproliferative disorders. Blood. Jan 15 1995;85(2):552-65. [Medline].
Starzl TE, Nalesnik MA, Porter KA. Reversibility of lymphomas and lymphoproliferative lesions developing under cyclosporin-steroid therapy. Lancet. Mar 17 1984;1(8377):583-7. [Medline].
Benkerrou M, Jais JP, Leblond V, et al. Anti-B-cell monoclonal antibody treatment of severe posttransplant B- lymphoproliferative disorder: prognostic factors and long-term outcome. Blood. Nov 1 1998;92(9):3137-47. [Medline].
Faro A, Kurland G, Michaels MG, et al. Interferon-alpha affects the immune response in post-transplant lymphoproliferative disorder. Am J Respir Crit Care Med. Apr 1996;153(4 Pt 1):1442-7. [Medline].
Shapiro RS, Chauvenet A, McGuire W, et al. Treatment of B-cell lymphoproliferative disorders with interferon alfa and intravenous gamma globulin. N Engl J Med. May 19 1988;318(20):1334. [Medline].
O'Brien S, Bernert RA, Logan JL, Lien YH. Remission of posttransplant lymphoproliferative disorder after interferon alfa therapy. J Am Soc Nephrol. Sep 1997;8(9):1483-9. [Medline].
Swinnen LJ, Costanzo-Nordin MR, Fisher SG, et al. Increased incidence of lymphoproliferative disorder after immunosuppression with the monoclonal antibody OKT3 in cardiac- transplant recipients. N Engl J Med. Dec 20 1990;323(25):1723-8. [Medline].
Leblond V, Sutton L, Dorent R, et al. Lymphoproliferative disorders after organ transplantation: a report of 24 cases observed in a single center. J Clin Oncol. Apr 1995;13(4):961-8. [Medline].
Fischer A, Blanche S, Le Bidois J, et al. Anti-B-cell monoclonal antibodies in the treatment of severe B-cell lymphoproliferative syndrome following bone marrow and organ transplantation. N Engl J Med. May 23 1991;324(21):1451-6. [Medline].
Milpied N, Vasseur B, Parquet N, et al. Humanized anti-CD20 monoclonal antibody (Rituximab) in post transplant B-lymphoproliferative disorder: a retrospective analysis on 32 patients. Ann Oncol. 2000;11 Suppl 1:113-6. [Medline].
Papadopoulos EB, Ladanyi M, Emanuel D. Infusions of donor leukocytes to treat Epstein-Barr virus-associated lymphoproliferative disorders after allogeneic bone marrow transplantation. N Engl J Med. Apr 28 1994;330(17):1185-91. [Medline].
Trigg ME, Finlay JL, Sondel PM. Prophylactic acyclovir in patients receiving bone marrow transplants. N Engl J Med. Jun 27 1985;312(26):1708-9. [Medline].
Darenkov IA, Marcarelli MA, Basadonna GP. Reduced incidence of Epstein-Barr virus-associated posttransplant lymphoproliferative disorder using preemptive antiviral therapy. Transplantation. Sep 27 1997;64(6):848-52. [Medline].
Davis CL, Harrison KL, McVicar JP. Antiviral prophylaxis and the Epstein Barr virus-related post- transplant lymphoproliferative disorder. Clin Transplant. Feb 1995;9(1):53-9. [Medline].
Birkeland SA, Andersen HK, Hamilton-Dutoit SJ. Preventing acute rejection, Epstein-Barr virus infection, and posttransplant lymphoproliferative disorders after kidney transplantation: use of acyclovir and mycophenolate mofetil in a steroid-free immunosuppressive protocol. Transplantation. May 15 1999;67(9):1209-14. [Medline].
Green M. Management of Epstein-Barr virus-induced post-transplant lymphoproliferative disease in recipients of solid organ transplantation. Am J Transplant. Jul 2001;1(2):103-8. [Medline].
Armitage JM, Kormos RL, Stuart RS, et al. Posttransplant lymphoproliferative disease in thoracic organ transplant patients: ten years of cyclosporine-based immunosuppression. J Heart Lung Transplant. Nov-Dec 1991;10(6):877-86; discussion 886-7. [Medline].
Bakker NA, van Imhoff GW. Post-transplant lymphoproliferative disorders: from treatment to early detection and prevention?. Haematologica. Nov 2007;92(11):1447-50. [Medline].
Becker YT, Samaniego-Picota M, Sollinger HW. The emerging role of rituximab in organ transplantation. Transpl Int. Aug 2006;19(8):621-8. [Medline].
Benkerrou M, Durandy A, Fischer A. Therapy for transplant-related lymphoproliferative diseases. Hematol Oncol Clin North Am. Apr 1993;7(2):467-75. [Medline].
Blanche S, Le Deist F, Veber F, et al. Treatment of severe Epstein-Barr virus-induced polyclonal B-lymphocyte proliferation by anti-B-cell monoclonal antibodies. Two cases after HLA- mismatched bone marrow transplantation. Ann Intern Med. Feb 1988;108(2):199-203. [Medline].
Borenstein J, Pezzella F, Gatter KC. Plasmablastic lymphomas may occur as post-transplant lymphoproliferative disorders. Histopathology. Dec 2007;51(6):774-7. [Medline].
Brunner B, Kropshofer G, Ellemunter H, Brunner A, Mueller T, Margreiter R. Severe cold agglutinin disease caused by recurrent monomorphic Epstein-Barr virus (EBV)-associated post-transplant lymphoproliferative disorder (PTLD), clonally related to an EBV-negative plasmacytic hyperplasia in a pediatric multivisceral organ transplant recipient. Pediatr Transplant. Aug 2007;11(5):547-51. [Medline].
Buadi FK, Heyman MR, Gocke CD, et al. Treatment and outcomes of post-transplant lymphoproliferative disease: a single institution study. Am J Hematol. Mar 2007;82(3):208-14. [Medline].
Burra P, Buda A, Livi U, et al. Occurrence of post-transplant lymphoproliferative disorders among over thousand adult recipients: any role for hepatitis C infection?. Eur J Gastroenterol Hepatol. Oct 2006;18(10):1065-70. [Medline].
Capello D, Berra E, Cerri M, Gaidano G. Post-transplant lymphoproliferative disorders. Molecular analysis of histogenesis and pathogenesis. Minerva Med. Feb 2004;95(1):53-64. [Medline].
Capello D, Cerri M, Muti G, et al. Analysis of immunoglobulin heavy and light chain variable genes in post-transplant lymphoproliferative disorders. Hematol Oncol. Dec 2006;24(4):212-9. [Medline].
Cen H, Williams PA, McWilliams HP, et al. Evidence for restricted Epstein-Barr virus latent gene expression and anti-EBNA antibody response in solid organ transplant recipients with posttransplant lymphoproliferative disorders. Blood. Mar 1 1993;81(5):1393-403. [Medline].
Cheeseman SH, Henle W, Rubin RH, et al. Epstein-Barr virus infection in renal transplant recipients. Effects of antithymocyte globulin and interferon. Ann Intern Med. Jul 1980;93(1):39-42. [Medline].
Cohen JI. Epstein-Barr virus infection. N Engl J Med. Aug 17 2000;343(7):481-92. [Medline].
Comoli P, Maccario R, Locatelli F, et al. Treatment of EBV-related post-renal transplant lymphoproliferative disease with a tailored regimen including EBV-specific T cells. Am J Transplant. Jun 2005;5(6):1415-22. [Medline].
D'Antiga L, Del Rizzo M, Mengoli C, Cillo U, Guariso G, Zancan L. Sustained Epstein-Barr virus detection in paediatric liver transplantation. Insights into the occurrence of late PTLD. Liver Transpl. Mar 2007;13(3):343-8. [Medline].
Deeg HJ, Socie G. Malignancies after hematopoietic stem cell transplantation: many questions, some answers. Blood. Mar 15 1998;91(6):1833-44. [Medline].
Dharnidharka VR, Araya CE. Post-transplant lymphoproliferative disease. Pediatr Nephrol. Sep 19 2007;[Medline].
Dharnidharka VR, Talley LI, Martz KL, Stablein DM, Fine RN. Recombinant growth hormone use pretransplant and risk for post-transplant lymphoproliferative disease - A report of the NAPRTCS. Pediatr Transplant. Dec 27 2007;[Medline].
Dhillon MS, Rai JK, Gunson BK, Olliff S, Olliff J. Post-transplant lymphoproliferative disease in liver transplantation. Br J Radiol. May 2007;80(953):337-46. [Medline].
Dolcetti R. B lymphocytes and Epstein-Barr virus: The lesson of post-transplant lymphoproliferative disorders. Autoimmun Rev. Dec 2007;7(2):96-101. [Medline].
Draoua HY, Tsao L, Mancini DM, et al. T-cell post-transplantation lymphoproliferative disorders after cardiac transplantation: a single institutional experience. Br J Haematol. Nov 2004;127(4):429-32. [Medline].
Epstein MA, Achong BG, Barr YM. Virus particles in cultured lymphoblasts from Burkitt's lymphoma. Lancet. 1964;1:702-3.
Fohrer C, Cailliard S, Koumarianou A. Long term survival in post-transplatn lymphoproliferative disorders with a dose-adjusted ACVBP regimen. Br J Hematol. 2006;134:601-12. [Medline].
Garner JG, Hirsch MS, Schooley RT. Prevention of Epstein-Barr virus-induced B-cell outgrowth by interferon alpha. Infect Immun. Mar 1984;43(3):920-4. [Medline].
Gautam A, Morrissey PE, Brem AS, et al. Use of an immune function assay to monitor immunosuppression for treatment of post-transplant lymphoproliferative disorder. Pediatr Transplant. Aug 2006;10(5):613-6. [Medline].
Ghobrial I, Habermann T, Ristow K, et al. Prognostic factors in patients with post-transplant lymphoproliferative disorders (PTLD) in the rituximab era. Leuk Lymphoma. Feb 2005;46(2):191-6. [Medline].
González-Barca E, Domingo-Domenech E, Capote FJ, Gómez-Codina J, Salar A, Bailen A. Prospective phase II trial of extended treatment with rituximab in patients with B-cell post-transplant lymphoproliferative disease. Haematologica. Nov 2007;92(11):1489-94. [Medline].
Gottschalk S, Rooney CM, Heslop HE. Post-transplant lymphoproliferative disorders. Annu Rev Med. Aug 11 2004.
Green M, Webber S. Posttransplantation lymphoproliferative disorders. Pediatr Clin North Am. Dec 2003;50(6):1471-91. [Medline].
Greenspan JS, Greenspan D, Lennette ET. Replication of Epstein-Barr virus within the epithelial cells of oral "hairy" leukoplakia, an AIDS-associated lesion. N Engl J Med. Dec 19 1985;313(25):1564-71. [Medline].
Gross TG. Post-transplant lymphoproliferative disease in children following solid organ transplant and rituximab--the final answer?. Pediatr Transplant. Sep 2007;11(6):575-7. [Medline].
Hanson MN, Morrison VA, Peterson BA, et al. Posttransplant T-cell lymphoproliferative disorders--an aggressive, late complication of solid-organ transplantation. Blood. Nov 1 1996;88(9):3626-33. [Medline].
Hanto DW, Frizzera G, Gajl-Peczalska KJ. Epstein-Barr virus, immunodeficiency, and B cell lymphoproliferation. Transplantation. May 1985;39(5):461-72. [Medline].
Hanto DW, Frizzera G, Gajl-Peczalska KJ. Epstein-Barr virus-induced B-cell lymphoma after renal transplantation: acyclovir therapy and transition from polyclonal to monoclonal B-cell proliferation. N Engl J Med. Apr 15 1982;306(15):913-8. [Medline].
Hayashida M, Ogita K, Matsuura T, Takahashi Y, Nishimoto Y, Ohga S. Successful prolonged rituximab treatment for post-transplant lymphoproliferative disorder following living donor liver transplantation in a child. Pediatr Transplant. Sep 2007;11(6):671-5. [Medline].
Henle G, Henle W, Diehl V. Relation of Burkitt's tumor-associated herpes-type virus to infectious mononucleosis. Proc Natl Acad Sci U S A. Jan 1968;59(1):94-101. [Medline].
Heslop HE, Savoldo B, Rooney CM. Cellular therapy of Epstein-Barr-virus-associated post-transplant lymphoproliferative disease. Best Pract Res Clin Haematol. Sep 2004;17(3):401-13. [Medline].
Jamali FR, Otrock ZK, Soweid AM, Al-Awar GN, Mahfouz RA, Haidar GR. An overview of the pathogenesis and natural history of post-transplant T-cell lymphoma. Leuk Lymphoma. Jun 2007;48(6):1237-41. [Medline].
Kessler M, Jay N, Molle R, Guillemin F. Excess risk of cancer in renal transplant patients. Transpl Int. Nov 2006;19(11):908-14. [Medline].
Kremers WK, Devarbhavi HC, Wiesner RH, Krom RA, Macon WR, Habermann TM. Post-transplant lymphoproliferative disorders following liver transplantation: incidence, risk factors and survival. Am J Transplant. May 2006;6(5 Pt 1):1017-24. [Medline].
LaCasce AS. Post-transplant lymphoproliferative disorders. Oncologist. Jun 2006;11(6):674-80. [Medline].
Lee TC, Savoldo B, Rooney CM, Heslop HE, Gee AP, Caldwell Y. Quantitative EBV viral loads and immunosuppression alterations can decrease PTLD incidence in pediatric liver transplant recipients. Am J Transplant. Sep 2005;5(9):2222-8. [Medline].
Lim WH, Russ GR, Coates PT. Review of Epstein-Barr virus and post-transplant lymphoproliferative disorder post-solid organ transplantation. Nephrology (Carlton). Aug 2006;11(4):355-66. [Medline].
Longo DL, DeVita VT Jr, Duffey PL, et al. Superiority of ProMACE-CytaBOM over ProMACE-MOPP in the treatment of advanced diffuse aggressive lymphoma: results of a prospective randomized trial. J Clin Oncol. Jan 1991;9(1):25-38. [Medline].
Meerbach A, Wutzler P, Häfer R, Zintl F, Gruhn B. Monitoring of Epstein-Barr virus load after hematopoietic stem cell transplantation for early intervention in post-transplant lymphoproliferative disease. J Med Virol. Mar 2008;80(3):441-54. [Medline].
Nalesnik MA, Makowka L, Starzl TE. The diagnosis and treatment of posttransplant lymphoproliferative disorders. Curr Probl Surg. Jun 1988;25(6):367-472. [Medline].
Pascual J. Post-transplant lymphoproliferative disorder--the potential of proliferation signal inhibitors. Nephrol Dial Transplant. May 2007;22 Suppl 1:i27-35. [Medline].
Penn I, Porat G. Central nervous system lymphomas in organ allograft recipients. Transplantation. Jan 27 1995;59(2):240-4. [Medline].
Preiksaitis JK. New developments in the diagnosis and management of posttransplantation lymphoproliferative disorders in solid organ transplant recipients. Clin Infect Dis. Oct 1 2004;39(7):1016-23. [Medline].
Riddler SA, Breinig MC, McKnight JL. Increased levels of circulating Epstein-Barr virus (EBV)-infected lymphocytes and decreased EBV nuclear antigen antibody responses are associated with the development of posttransplant lymphoproliferative disease in solid-organ transplant recipients. Blood. Aug 1 1994;84(3):972-84. [Medline].
Rinaldi A, Kwee I, Poretti G, Mensah A, Pruneri G, Capello D. Comparative genome-wide profiling of post-transplant lymphoproliferative disorders and diffuse large B-cell lymphomas. Br J Haematol. Jul 2006;134(1):27-36. [Medline].
Rooney CM, Smith CA, Ng CY, et al. Infusion of cytotoxic T cells for the prevention and treatment of Epstein-Barr virus-induced lymphoma in allogeneic transplant recipients. Blood. Sep 1 1998;92(5):1549-55. [Medline].
Scarsbrook AF, Warakaulle DR, Dattani M, Traill Z. Post-transplantation lymphoproliferative disorder: the spectrum of imaging appearances. Clin Radiol. Jan 2005;60(1):47-55. [Medline].
Schubert S, Renner C, Hammer M, Abdul-Khaliq H, Lehmkuhl HB, Berger F. Relationship of immunosuppression to Epstein-Barr viral load and lymphoproliferative disease in pediatric heart transplant patients. J Heart Lung Transplant. Jan 2008;27(1):100-5. [Medline].
Shaknovich R, Basso K, Bhagat G, et al. Identification of rare Epstein-Barr virus infected memory B cells and plasma cells in non-monomorphic post-transplant lymphoproliferative disorders and the signature of viral signaling. Haematologica. Oct 2006;91(10):1313-20. [Medline].
Shapiro RS. Epstein-Barr virus-associated B-cell lymphoproliferative disorders in immunodeficiency: meeting the challenge. J Clin Oncol. Mar 1990;8(3):371-3. [Medline].
Snow AL, Vaysberg M, Krams SM, Martinez OM. EBV B lymphoma cell lines from patients with post-transplant lymphoproliferative disease are resistant to TRAIL-induced apoptosis. Am J Transplant. May 2006;6(5 Pt 1):976-85. [Medline].
Taj MM, Messahel B, Mycroft J, Pritchard-Jones K, Baker A, Height S. Efficacy and tolerability of high-dose methotrexate in central nervous system positive or relapsed lymphoproliferative disease following liver transplant in children. Br J Haematol. Jan 2008;140(2):191-6. [Medline].
Wagner HJ, Cheng YC, Huls MH, et al. Prompt versus preemptive intervention for EBV lymphoproliferative disease. Blood. May 15 2004;103(10):3979-81. [Medline].
Ziegler JL, Drew WL, Miner RC, et al. Outbreak of Burkitt's-like lymphoma in homosexual men. Lancet. Sep 18 1982;2(8299):631-3. [Medline].
zur Hausen H, Schulte-Holthausen H, Klein G, et al. EBV DNA in biopsies of Burkitt tumours and anaplastic carcinomas of the nasopharynx. Nature. Dec 12 1970;228(276):1056-8. [Medline].
Further Reading
Keywords
posttransplant lymphoproliferative disorder, PTLD, Epstein-Barr virus, EBV, immunosuppression, bone marrow transplantation, solid organ transplantation, posttransplantation infectious mononucleosis, posttransplantation plasma cell hyperplasia, posttransplantation reactive hyperplasias, polymorphic lymphoma, polymorphic B-cell hyperplasia, lymphomatous PTLD




Multimedia: Posttransplant Lymphoproliferative Disease