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Erschienen in: Indian Journal of Hematology and Blood Transfusion 2/2020

17.09.2019 | Review

Post Transplant Lymphoproliferative Disorder

verfasst von: Devika Gupta, Satish Mendonca, Sushmita Chakraborty, Tathagata Chatterjee

Erschienen in: Indian Journal of Hematology and Blood Transfusion | Ausgabe 2/2020

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Abstract

Posttransplant lymphoproliferative disorder is an extremely fatal complication arising in transplant recipients as a side effect of immunosuppression. PTLDs are seen after both solid organ and hematopoietic stem cell transplants though the incidence is much higher in the former. Primary Epstein–Barr virus (EBV) infection or reactivation due to a state of immune dysregulation along with intensity of immunosuppression used are of paramount importance in pathogenesis of PTLD. EBV associated PTLDs occur early in the post transplant period whereas late onset lymphomas are usually EBV negative. The uncontrolled B cell proliferation can create a spectrum of histological patterns from nondestructive lesions to destructive polymorphic or more aggressive monomorphic PTLDs. Early detection of seropositivity by serial monitoring in the recipient can prevent PTLD development by starting pre-emptive therapy. The mainstay treatment in established cases remains reduction of immunosuppression. Chemotherapeutic and immunomodulatory agents are added sequentially based on the type of PTLD and based on its response to initial therapy. Despite various treatment options available, the morbidity remains high and achieving state of disease remission without causing graft rejection can be quite challenging. Hence, a better understanding in pathobiology of EBV+ versus EBV− PTLDS may help prevent lymphomagenesis in transplant recipients.
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Metadaten
Titel
Post Transplant Lymphoproliferative Disorder
verfasst von
Devika Gupta
Satish Mendonca
Sushmita Chakraborty
Tathagata Chatterjee
Publikationsdatum
17.09.2019
Verlag
Springer India
Erschienen in
Indian Journal of Hematology and Blood Transfusion / Ausgabe 2/2020
Print ISSN: 0971-4502
Elektronische ISSN: 0974-0449
DOI
https://doi.org/10.1007/s12288-019-01182-x

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