Iatrogenic Immunodeficiency-Associated Lymphoproliferative Disorders

Swerdlow, Steven H.; Craig, Fiona E.

doi:10.1016/b978-0-7216-0040-6.00055-1

Cited by 10 publications

(10 citation statements)

References 131 publications

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“…[10][11][12][13][14][15] The histopathologic criteria of PTLD were defined by Swerdlow and Greig. 16 The WHO classification is most commonly used, with four types of morphological lesions being recognized: polyclonal early lesions, polymorphic, monomorphic (B-cell or T/NK-cell) and classical Hodgkin lymphoma-type PTLD.…”

Section: Definitions and Diagnostic Criteriamentioning

confidence: 99%

Management of Epstein-Barr Virus infections and post-transplant lymphoproliferative disorders in patients after allogeneic hematopoietic stem cell transplantation: Sixth European Conference on Infections in Leukemia (ECIL-6) guidelines

Styczyński¹,

Velden²,

Fox³

et al. 2016

Haematologica

306

375

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E pstein-Barr virus-related post-transplant lymphoproliferative disorders are recognized as a significant cause of morbidity and mortality in patients undergoing hematopoietic stem cell transplantation. To better define current understanding of post-transplant lymphoproliferative disorders in stem cell transplant patients, and to improve its diagnosis and management, a working group of the Sixth European Conference on Infections in Leukemia 2015 reviewed the literature, graded the available quality of evidence, and developed evidence-based recommendations for diagnosis, prevention, prophylaxis and therapy of post-transplant lymphoproliferative disorders exclusively in the stem cell transplant setting. The key elements in diagnosis include non-invasive and invasive methods. The former are based on quantitative viral load measurement and imaging with positron emission tomography; the latter with tissue biopsy for histopathology and detection of Epstein-Barr virus. The diagnosis of post-transplant lymphoproliferative disorder can be established on a proven or probable level. Therapeutic strategies include prophylaxis, preemptive therapy and targeted therapy. Rituximab, reduction of immunosuppression and Epstein-Barr virusspecific cytotoxic T-cell therapy are recommended as first-line therapy, whilst unselected donor lymphocyte infusions or chemotherapy are options as second-line therapy; other methods including antiviral drugs are discouraged. Management of Epstein-Barr Virus infections

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Section: Definitions and Diagnostic Criteriamentioning

confidence: 99%

Management of Epstein-Barr Virus infections and post-transplant lymphoproliferative disorders in patients after allogeneic hematopoietic stem cell transplantation: Sixth European Conference on Infections in Leukemia (ECIL-6) guidelines

Styczyński¹,

Velden²,

Fox³

et al. 2016

Haematologica

306

375

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“…It is well known that immunodeficiency‐associated lymphoid proliferations or lymphomas can arise in patients treated with MTX, known as MTX‐associated lymphoproliferative disorders (MTX‐LPDs). According to the revised fourth edition of the WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues, 18 MTX‐LPDs are divided into several types: B‐cell lymphomas, T‐cell LPDs/lymphomas, Hodgkin lymphomas, and some others; and B‐cell lymphomas are the most frequent and predominant as a type of MTX‐LPD. Among these B‐cell lymphomas, DLBCL is the most frequent and predominant subtype; furthermore, a certain fraction of the cases of DLBCL are not EBV‐positive.…”

Section: Discussionmentioning

confidence: 99%

Primary cauda equina lymphoma confirmed by autopsy: A case report

Ishizawa,

Komori,

Shimazaki

et al. 2023

Neuropathology

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Compared with those involving the central nervous system, lymphomas involving the peripheral nervous system, namely neurolymphomatosis, are extremely rare. Neurolymphomatosis is classified as primary or secondary; the former is much rarer than the latter. Herein, we present an autopsied case of primary cauda equina lymphoma (PCEL), a type of primary neurolymphomatosis, with a literature review of autopsied cases of PCEL as well as primary neurolymphomatosis other than PCEL (non‐PCEL primary neurolymphomatosis). A 70‐year‐old woman presented with difficulty walking, followed by paraplegia and then bladder and bowel disturbance. On magnetic resonance imaging, the cauda equina was diffusely enlarged and enhanced with gadolinium. The brainstem and cerebellum were also enhanced with gadolinium along their surface. The differential diagnosis of the patient included meningeal tumors (other than lymphomas), lymphomas, or sarcoidosis. The biopsy of the cauda equina was planned for a definite diagnosis, but because the patient deteriorated so rapidly, it was not performed. Eventually, she was affected by cranial nerve palsies. With the definite diagnosis being undetermined, the patient died approximately 1.5 years after the onset of disesase. At autopsy, the cauda equina was replaced by a bulky mass composed of atypical B‐lymphoid cells, consistent with diffuse large B‐cell lymphoma (DLBCL). The spinal cord was heavily infiltrated, as were the spinal/cranial nerves and subarachnoid space. There was metastasis in the left adrenal. The patient was finally diagnosed postmortem as PCEL with a DLBCL phenotype. To date, there have been a limited number of autopsied cases of PCEL and non‐PCEL primary neurolymphomatosis (nine cases in all, including ours). The diagnosis is, without exception, B‐cell lymphoma including DLBCL, and the histology features central nervous system parenchymal infiltration, nerve root involvement, and subarachnoid dissemination (lymphomatous meningitis). Metastases are not uncommon. All clinicians and pathologists should be aware of lymphomas primarily involving the peripheral nervous system.

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“…The World Health Organization distinguishes 4 categories of immunodeficiency-associated LPDs (IA-LPDs): posttransplant LPDs, lymphomas associated with HIV infection, LPDs associated with primary immune disorders, and other iatrogenic immunodeficiency-associated LPDs. 1 Methotrexate is the most common agent associated with LPDs, although other immunosuppressive agents have been reported, including thiopurines, tumor necrosis factor antagonists, and cyclosporine. 2,3 The case we reported here developed an LPD after increasing the dosage of adalimumab.…”

Section: Discussionmentioning

confidence: 99%

A Rare Case of Epstein-Barr Virus–Positive T-Cell Lymphoma in the Skin of an Immunocompromised Patient

Eijk

Koldijk

Kester

et al. 2021

The American Journal of Dermatopathology

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:Immunodeficiency-associated lymphoproliferative disorders are associated with latent infection by Epstein–Barr virus (EBV). Most cases of EBV-positive immunodeficiency-associated lymphoproliferative disorders arise from B cells, although some are of T-cell or natural killer origin. Cutaneous involvement is unusual and sporadically reported in the literature. We describe a rare case of an EBV-positive T-cell lymphoma presenting in the skin of a 32-year-old woman using adalimumab for neurosarcoidosis.

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Iatrogenic Immunodeficiency-Associated Lymphoproliferative Disorders

Cited by 10 publications

References 131 publications

Management of Epstein-Barr Virus infections and post-transplant lymphoproliferative disorders in patients after allogeneic hematopoietic stem cell transplantation: Sixth European Conference on Infections in Leukemia (ECIL-6) guidelines

Management of Epstein-Barr Virus infections and post-transplant lymphoproliferative disorders in patients after allogeneic hematopoietic stem cell transplantation: Sixth European Conference on Infections in Leukemia (ECIL-6) guidelines

Primary cauda equina lymphoma confirmed by autopsy: A case report

A Rare Case of Epstein-Barr Virus–Positive T-Cell Lymphoma in the Skin of an Immunocompromised Patient

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