Role of Chemotherapy and Rituximab for Treatment of Posttransplant Lymphoproliferative Disorder in Solid Organ Transplantation

Lee, Jin-Joo; Lam, Masha S. H.; Rosenberg, Amy F

doi:10.1345/aph.1k175

Cited by 35 publications

(22 citation statements)

References 28 publications

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“…The use of rituximab, especially with less-intensive chemotherapy regimens, is becoming more popular after observing promising results in clinical trials [89][90][91]. More aggressive or conventional chemotherapy can achieve response rates between 74 and 100% when combined with rituximab [92], but it is reserved as the ultimate resort or for monomorphic, late onset, EBV-negative or T-cell PTLD [55].…”

Section: Opportunistic Viral Infections In Intestinal Transplantationmentioning

confidence: 99%

Opportunistic viral infections in intestinal transplantation

Florescu

Langnas

Sandkovsky

2013

Expert Review of Anti-infective Therapy

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Intestinal transplantation (IT) has become a standard treatment for patients with intestinal failure and complications of parenteral nutrition. The pool of intestinal transplant recipients has been slowly growing over the last two decades. Of the 2191 ITs performed between 1 January 1990 and 31 March 2012, 50.5% were children less than 10 years of age. Survival rates at 1, 5 and 10 years have been reported to be 78.5, 58.2 and 47%, respectively. IT restores organ functions, but it is associated with complications, with infections representing the major cause of morbidity and mortality in this population.

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Section: Opportunistic Viral Infections In Intestinal Transplantationmentioning

confidence: 99%

Opportunistic viral infections in intestinal transplantation

Florescu

Langnas

Sandkovsky

2013

Expert Review of Anti-infective Therapy

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“…The median survival for PTLD in the rituximab era is 14 months, with patients who have only a partial response to rituximab and stage IV disease faring worse [80]. Salvage therapy for rituximab failures includes CHOPlike chemotherapy regimens with CR rates of 70% reported, although this comes at the expense of significant treatment-related toxicity and treatmentrelated mortality rates of approximately 25%, resulting from underlying immunosuppression, limited bone marrow reserve, altered renal function, and chemoresistance [86,87]. However, an overall survival duration of 46 months has been reported in one study [86], reinforcing the need to consider salvage chemotherapy in appropriate patients.…”

Section: Pancytopenia Related To Post-transplant Hematopoietic Malignmentioning

confidence: 99%

Hematologic abnormalities following renal transplantation

Marinella

2009

Int Urol Nephrol

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Recipients of renal allografts are surviving longer and, consequently, may experience a variety of complications related not only to the transplanted kidney, but also to the hematopoietic system. Common hematologic complications in the renal transplant patient include abnormalities of one cell line, such as post-transplantation erythrocytosis or anemia, that are often treatable with simple measures. Conversely, pathologies involving the leukocyte and platelet population often exist in the context of pancytopenia, which may be a manifestation of systemic infection (e.g., cytomegalovirus, human herpesvirus 8) or malignancy (post-transplantation lymphoproliferative disorders). Uncommon, but life-threatening, processes complicating renal transplantation include hepatosplenic gammadelta T-cell lymphoma and viral-induced hemophagocytic syndrome, both of which are associated with severe pancytopenia and, often, death. Since this patient population is often managed in a multidisciplinary fashion by nephrologists, infection specialists, transplant surgeons, hematologists, and internal medicine physicians, a succinct review of this topic is warranted.

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“…Monoclonal variants of PTLD may need administration of anti-CD20 monoclonal antibody (Rituximab) and chemotherapy [8]. In our cohort we had another case that responded well to immunosuppressive dose reduction and Rituximab therapy.…”

Section: (Figure 1)mentioning

confidence: 94%