Examining the Origin of Posttransplant Lymphoproliferative Disorder in a Patient After a Second Allogeneic Hematopoeitic Stem Cell Transplantation for Relapsed BCR-ABL Positive Acute Lymphoblastic Leukemia

Ruf, Stephanie; Moser, Olga; Wömann, Wilhelm; Kreyenberg, Hermann; Wagner, Hans‐Joachim

doi:10.1097/mph.0b013e3181ed336f

Cited by 6 publications

(5 citation statements)

References 8 publications

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“…Disparities in the timing of the peak incidence between SOT and HSCT suggest differences in etiologic pathways as well. In fact, typical SOT‐related PTLDs develop from recipient cells, whereas most HSCT‐associated PTLDs arise from donor cells; this further adds to the complexity of characterizing oncogenesis in this heterogeneous disease …”

Section: Discussionmentioning

confidence: 99%

“…In fact, typical SOT-related PTLDs develop from recipient cells, while most HSCT-associated PTLDs arise from donor cells, further adding to the complexity of characterizing oncogenesis in this heterogeneous disease. 26–28…”

Section: Discussionmentioning

confidence: 99%

“…In fact, typical SOT-related PTLDs develop from recipient cells, whereas most HSCT-associated PTLDs arise from donor cells; this further adds to the complexity of characterizing oncogenesis in this heterogeneous disease. [26][27][28] Perhaps unsurprisingly, other major risk factors for PTLD development relate to modulations of the immune milieu. Reported risk factors in SOT include the transplantation of lymphoid-rich organs such as the lung and intestine and transplantation from an EBVseropositive donor to an EBV-seronegative recipient, whereas risk factors in HSCT include T-cell-depleted grafts, human leukocyte antigen mismatch, and primary immunodeficiency.…”

Section: Potential Factors Underlying Subtype-specific Outcomes Of Ptldmentioning

confidence: 99%

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Impact of the posttransplant lymphoproliferative disorder subtype on survival

Koff

Zhang

et al. 2018

Cancer

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Potential Factors Underlying Subtype-specific Outcomes Of Ptldmentioning

confidence: 99%

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Impact of the posttransplant lymphoproliferative disorder subtype on survival

Koff

Zhang

et al. 2018

Cancer

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“…This opens opportunities for donor-derived EBV-infected B cells populating the severely immunocompromised host serving as an additional origin of EBV-PTLD after HCT and providing a timely delay of EBV-PTLD development. 1 The occurrence of EBV-PTLD after cord blood transplantation where the donor has unlikely been infected with EBV in the first place, however, represents an example of clearly host-derived EBV-PTLD. 2,3 Published experience regarding the incidence of EBV-PTLD after allogeneic HCT ranges between 0.5 and 17% and is mainly based on single-centre experiences or retrospective studies limited by small numbers and diverse patient characteristics.…”

Section: Introductionmentioning

confidence: 99%

EBV-induced post transplant lymphoproliferative disorders: a persisting challenge in allogeneic hematopoetic SCT

Rasche

Kapp

Einsele

et al. 2013

Bone Marrow Transplant

118

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EBV-induced post transplantation lymphoproliferative disorder (EBV-PTLD) is a life-threatening complication after allogeneic hematopoietic cell transplantation. Profound T-cell depletion of the allograft represents a major risk factor for EBV-PTLD. With regard to the increasing use of alternative stem cell sources such as cord blood or purified haploidentical stem cell grafts both associated with impaired immune reconstitution, the frequent occurrence of EBV-PTLD demands particular vigilance on laboratory changes and early symptoms. Here we have summarized today's knowledge about EBV-PTLD in a comprehensive review explaining the underlying mechanisms of EBV-based transformation, EBV-PTLD development, clinical presentation, incidence, diagnosis, screening, therapy and prognosis. In this context, we emphasize on the necessity of regularly applied screening tools and pre-emptive treatment strategies including anti-CD20 Abs particularly in high-risk patients to avoid disease progression to malignant lymphoma. Although EBV-PTLD has always been associated with a high mortality rate, novel immunotherapeutic approaches such as the transfer of EBV-specific T cells nowadays offer improved chances of disease control even at late stages.

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“…Primary infection develops after contact with infected saliva or other secretions [9]. Although EBV is typical of recipient origin after SOT, donor-derived B-cells are usually the source of EBV-induced lymphoproliferation in HSCT [10].…”

Section: Ebv-positive Ptldmentioning

confidence: 99%

Post-Transplant Lymphoproliferative Disease (PTLD) after Allogeneic Hematopoietic Stem Cell Transplantation: Biology and Treatment Options

Clerico

Dogliotti

Consoli

et al. 2022

JCM

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Post-transplant lymphoproliferative disease (PTLD) is a serious complication occurring as a consequence of immunosuppression in the setting of allogeneic hematopoietic stem cell transplantation (alloHSCT) or solid organ transplantation (SOT). The majority of PTLD arises from B-cells, and Epstein–Barr virus (EBV) infection is present in 60–80% of the cases, revealing the central role played by the latent infection in the pathogenesis of the disease. Therefore, EBV serological status is considered the most important risk factor associated with PTLDs, together with the depth of T-cell immunosuppression pre- and post-transplant. However, despite the advances in pathogenesis understanding and the introduction of novel treatment options, PTLD arising after alloHSCT remains a particularly challenging disease, and there is a need for consensus on how to treat rituximab-refractory cases. This review aims to explore the pathogenesis, risk factors, and treatment options of PTLD in the alloHSCT setting, finally focusing on adoptive immunotherapy options, namely EBV-specific cytotoxic T-lymphocytes (EBV-CTL) and chimeric antigen receptor T-cells (CAR T).

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Examining the Origin of Posttransplant Lymphoproliferative Disorder in a Patient After a Second Allogeneic Hematopoeitic Stem Cell Transplantation for Relapsed BCR-ABL Positive Acute Lymphoblastic Leukemia

Abstract: This case shows that EBV-infected B cells from a first donor can be the source of a PTLD after a second myeloablative HSCT from a different donor.

Cited by 6 publications

References 8 publications

Impact of the posttransplant lymphoproliferative disorder subtype on survival

Impact of the posttransplant lymphoproliferative disorder subtype on survival

EBV-induced post transplant lymphoproliferative disorders: a persisting challenge in allogeneic hematopoetic SCT

Post-Transplant Lymphoproliferative Disease (PTLD) after Allogeneic Hematopoietic Stem Cell Transplantation: Biology and Treatment Options

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