Posttransplant Lymphoma A Single-Center Experience of 500 Liver Transplantations

Norin, Stefan; Kimby, Eva; Ericzon, Bo‐Göran; Christensson, Birger; Sander, Birgitta; Söderdahl, Gunnar; Hägglund, Hans

doi:10.1385/mo:21:3:273

Cited by 50 publications

(27 citation statements)

References 25 publications

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“…Haematologica 2007; 92: [273][274] Chemotherapy is effective in PTLD, but is associated with significant toxicity, including substantial treatmentrelated mortality (TRM). Reports of chemotherapy in PTLD are generally based on small cohorts, including patients with a broad spectrum of different subtypes of PTLD, and heterogeneous chemotherapy regimens, [1][2][3][4][5][6][7] ( Table 1, online version only). A large retrospective analysis, however, has demonstrated improved overall survival (OS) with multidrug regimens compared with single-agent chemotherapy in PTLD.…”

Section: Chop-21 For the Treatment Of Post-transplant Lymphoproliferamentioning

confidence: 99%

CHOP-21 for the treatment of post-transplant lymphoproliferative disorders following solid organ transplantation

Choquet¹,

Trappe²,

Leblond³

et al. 2007

Haematologica

142

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Section: Chop-21 For the Treatment Of Post-transplant Lymphoproliferamentioning

confidence: 99%

CHOP-21 for the treatment of post-transplant lymphoproliferative disorders following solid organ transplantation

Choquet¹,

Trappe²,

Leblond³

et al. 2007

Haematologica

142

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“…Additionally, IR is known to be associated with a high risk of graft rejection and graft loss, and a rejection rate of 37% has recently been reported in a first prospective trial systematically evaluating IR in PTLD (10). Subsequent therapies in patients failing to respond significantly to upfront IR are rituximab monotherapy in CD20-positive B-cell PTLD (11)(12)(13)(14), CHOP-like chemotherapy (15)(16)(17)(18)(19) (11)(12)(13)(14) and up to 90% for sequential treatment with four courses of rituximab followed by four cycles of CHOP have been reported (20) …”

mentioning

confidence: 99%

Treatment of PTLD with Rituximab and CHOP Reduces the Risk of Renal Graft Impairment after Reduction of Immunosuppression

Trappe¹,

Hinrichs

Appel³

et al. 2009

American Journal of Transplantation

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We addressed the effect of post-transplant lymphoproliferative disorder (PTLD) treatment with rituximab monotherapy or CHOP-based chemotherapy (± rituximab) after upfront immunosuppression reduction (IR) on renal graft function in a longitudinal analysis of 58 renal transplant recipients with PTLD and 610 renal transplant controls. Changes in the estimated glomerular filtration rate over time were calculated from a total of 6933 creatinine measurements over a period of >1 year using a linear mixed model with random and fixed effects. Renal graft function significantly improved with treatment of PTLD, especially in the chemotherapy subgroup. Patients treated with IR + chemotherapy ± rituximab had a noninferior graft function compared with untreated controls suggesting that the negative impact of IR on the renal graft function can be fully compensated by the immunosuppressive effect of CHOP. The immunosuppressive effect of single agent rituximab may partially compensate the negative impact of IR on the graft function. Thus, it is possible to reduce immunosuppression when using chemotherapy to treat PTLD.

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“…Treatment of post-transplant lymphoproliferative disease has probably seen the greatest use of rituximab with great success, but there is no formal indication for this use (42,43). In nontransplant patients with lymphoma, rituximab is typically combined with other chemotherapeutic agents with somewhat worse results (44).…”

Section: Off Label Rituximab Use In Transplant Patientsmentioning

confidence: 99%

Rituximab, an Anti-CD20 Monoclonal Antibody: History and Mechanism of Action

Pescovitz

2006

American Journal of Transplantation

547

352

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Rituximab, chimeric anti-human CD20, is approved for treatment of B-cell lymphoma in adults. It is being used experimentally in other various immune-related diseases such as immune thrombocytopenic purpura, systemic lupus erythematosus, myasthenia gravis and rheumatoid arthritis. In transplant recipients, it is used for treatment of post-transplant lymphoproliferative disease, to anecdotally reduce pre-formed anti-HLA and anti-ABO antibodies and for the prevention and treatment of acute rejection. This article primarily reviews the science behind rituximab: its history, pharmacokinetics and potential mechanism of action. A need for controlled clinical trials is clearly indicated before the widespread use of this drug in transplant.

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Posttransplant Lymphoma A Single-Center Experience of 500 Liver Transplantations

Abstract: PTLD is a significant complication in liver-transplanted patients. Intensive chemotherapy can induce long-term remissions in a substantial number of patients. The role for monoclonal antibodies in this setting should be investigated further.

Cited by 50 publications

References 25 publications

CHOP-21 for the treatment of post-transplant lymphoproliferative disorders following solid organ transplantation

CHOP-21 for the treatment of post-transplant lymphoproliferative disorders following solid organ transplantation

Treatment of PTLD with Rituximab and CHOP Reduces the Risk of Renal Graft Impairment after Reduction of Immunosuppression

Rituximab, an Anti-CD20 Monoclonal Antibody: History and Mechanism of Action

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