Cancer-infection interface in children after transplantation: posttransplant lymphoproliferative disorder and Epstein-Barr virus infection

被引：8

作者：

Fujieda, Mikiya ^{[1
]}

Hattori, Motoshi ^{[2
]}

机构：

[1] Kochi Univ, Kochi Med Sch, Dept Paediat, Kochi 780, Japan

[2] Tokyo Womens Med Univ, Kidney Ctr, Dept Paediat, Tokyo, Japan

来源：

CURRENT OPINION IN ORGAN TRANSPLANTATION | 2013年 / 18卷 / 05期

关键词：

Epstein-Barr virus; pediatric transplantation; PTLD; GENE-EXPRESSION; LOAD; RECIPIENTS; DISEASE; RISK; PTLD; SEROSTATUS; RITUXIMAB; ANTIBODY; VIREMIA;

D O I：

10.1097/MOT.0b013e3283651b0d

中图分类号：

R3 [基础医学]; R4 [临床医学];

学科分类号：

1001 ; 1002 ; 100602 ;

摘要：

Purpose of reviewTo summarize the association between posttransplant lymphoproliferative disorder (PTLD), which is the most frequent cause of posttransplantation tumors in children, and Epstein-Barr virus (EBV) infection.Recent findingsMost PTLD cases present as proliferation of EBV-infected B cells, because EBV-naive patients have no EBV-specific cytotoxic lymphocytes to control the infected cells. The monitoring of EBV loads in whole blood, as well as in plasma by PCR, represents a useful method for early diagnosis and timely treatment. A program of EBV control by molecular EBV monitoring coupled with lymphocyte phenotype analysis is recommended. Pre-emptive reduced immunosuppression may prevent PTLD, and improved therapeutic options may also contribute to milder PTLD phenotype and improved clinical course.SummaryA recent trend is that PTLD incidence and high-grade histological findings have decreased because of appropriate immunosuppressive maintenance doses, monitoring of EBV, and preemptive treatment. More sensitive, specific tools for the detection of EBV replication and prophylactic methods are required to establish a definitive strategy for the prevention of PTLD after transplantation.

引用

页码：549 / 554

页数：6

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