Current Practices on Diagnosis, Prevention and Treatment of Post-Transplant Lymphoproliferative Disorder in Pediatric Patients after Solid Organ Transplantation: Results of ERN TransplantChild Healthcare Working Group Survey

被引：27

作者：

Baker, Alastair ^{[1
]}

Frauca Remacha, Esteban ^{[2
]}

Torres Canizales, Juan ^{[3
,4
]}

Yadira Bravo-Gallego, Luz ^{[3
,4
]}

Fitzpatrick, Emer ^{[1
]}

Alonso Melgar, Angel ^{[5
]}

Munoz Bartolo, Gema ^{[2
]}

Garcia Guereta, Luis ^{[6
]}

Ramos Boluda, Esther ^{[7
]}

Mozo, Yasmina ^{[8
]}

Broniszczak, Dorota ^{[9
]}

Jarmuzek, Wioletta ^{[10
]}

Kalicinski, Piotr ^{[9
]}

Maecker-Kolhoff, Britta ^{[11
]}

Carlens, Julia ^{[12
]}

Baumann, Ulrich ^{[13
]}

Roy, Charlotte ^{[14
]}

Chardot, Christophe ^{[15
]}

Benetti, Elisa ^{[16
]}

Cananzi, Mara ^{[17
]}

Calore, Elisabetta ^{[18
]}

Dello Strologo, Luca ^{[19
]}

Candusso, Manila ^{[20
]}

Lopes, Maria Francelina ^{[21
,22
]}

Brito, Manuel Joao ^{[23
,24
]}

Goncalves, Cristina ^{[25
]}

Do Carmo, Carmen ^{[26
]}

Stephenne, Xavier ^{[27
]}

Wennberg, Lars ^{[28
]}

Stone, Rosario ^{[29
]}

Rascon, Jelena ^{[30
]}

Lindemans, Caroline ^{[31
]}

Turkiewicz, Dominik ^{[32
]}

Giraldi, Eugenia ^{[33
]}

Nicastro, Emanuele ^{[34
]}

D'Antiga, Lorenzo ^{[34
]}

Ackermann, Oanez ^{[35
]}

Jara Vega, Paloma ^{[2
,36
]}

机构：

[1] Kings Coll London, Kings Coll Hosp, Sch Med, Paediat Liver Gastrointestinal & Nutr Ctr, Denmark Hill, London SE5 9RS, England

[2] Hosp Univ La Paz, Serv Hepatol Pediat, Madrid 28046, Spain

[3] Hosp Univ La Paz, Lymphocyte Pathophysiol Immunodeficiencies Grp, La Paz Inst Biomed Res IdiPAZ, Madrid 28046, Spain

[4] Ctr Biomed Network Res Rare Dis CIBERER U767, Madrid 28046, Spain

[5] Hosp Univ La Paz, Serv Nefrol Pediat, Madrid 28046, Spain

[6] Hosp Univ La Paz, Serv Cardiol Pediat, Madrid 28046, Spain

[7] Univ Hosp La Paz, Pediat Gastroenterol Intestinal Rehabil Unit, Madrid 28046, Spain

[8] Hosp Univ La Paz, Pediat Hematooncol Dept, Madrid 28046, Spain

[9] Childrens Mem Hlth Inst, Dept Pediat Surg & Organ Transplantat, PL-04730 Warsaw, Poland

[10] Childrens Mem Hlth Inst, Dept Nephrol & Kidney Transplantat, PL-04730 Warsaw, Poland

[11] Hannover Med Sch, Dept Pediat Hematol & Oncol, D-30625 Hannover, Germany

[12] Hannover Med Sch, Clin Paediat Pneumol Allergol & Neonatol, D-30625 Hannover, Germany

[13] Childrens Hosp, Hannover Med Sch, Div Paediat Gastroenterol & Hepatol, D-30625 Hannover, Germany

[14] Univ Paris, AP HP, Hop Necker Enfants Malad, Serv Pneumol Pediat, F-75015 Paris, France

[15] Univ Paris 05, AP HP, Hop Necker Enfants Malad, Serv Chirurg Pediat, F-75015 Paris, France

[16] Azienda Osped Padova, Dialysis & Transplant Unit, Dept Womens & Childrens Hlth, Pediat Nephrol, I-35128 Padua, Italy

[17] Azienda Osped Padova, Unit Paediat Gastroenterol Digest Endoscopy Hepat, Dept Womens & Childrens Hlth, I-35128 Padua, Italy

[18] Azienda Osped Padova, Dept Womens & Childrens Hlth, Unit Paediat Oncohaematol, I-35128 Padua, Italy

[19] Bambino Gesu Childrens Res Hosp, Nephrol Unit, IRCCS, I-00165 Rome, Italy

[20] Bambino Gesu Children Hosp, Dept Hepatol & Gastroenterol, I-00165 Rome, Italy

[21] Univ Coimbra, Dept Paediat Surg, Ctr Hosp & Univ Coimbra, P-3000075 Coimbra, Portugal

[22] Univ Coimbra, Fac Med, P-3000075 Coimbra, Portugal

[23] Ctr Hosp & Univ Coimbra, Dept Paediat Oncol, P-3000075 Coimbra, Portugal

[24] Ctr Hosp & Univ Coimbra, Ctr Invest & Formacao Clin, Hosp Pediatr, P-3000075 Coimbra, Portugal

[25] Ctr Hosp & Univ Coimbra, Paediat Liver Transplant Unit, P-3000075 Coimbra, Portugal

[26] Ctr Hosp & Univ Coimbra, Hosp Pediatr, Paediat Nephrol Unit, P-3000075 Coimbra, Portugal

[27] Univ Catholique Louvain UCLouvain, Inst Rech Expt & Clin, Lab Hepatol Pediat & Therapie Cellulaire, Unite PEDI, B-1200 Brussels, Belgium

[28] Karolinska Univ Hosp, Dept Transplantat Surg, S-17176 Stockholm, Sweden

[29] Univ Lisbon, Unidade Nefrol & Transplantacao Renal, Serv Pediat Med, Ctr Acad Med,Dept Pediat,Hosp Santa Maria, P-1649028 Lisbon, Portugal

[30] Vilnius Univ Hosp Santaros Klin, Ctr Paediat Oncol & Haematol, LT-08406 Vilnius, Lithuania

[31] Univ Utrecht, Univ Med Ctr Utrecht, Princess Maxima Ctr Pediat Oncol, Pediat Blood & Marrow Transplantat Program, NL-3584 CS Utrecht, Netherlands

[32] Skane Univ Hosp, Dept Pediat, S-22242 Lund, Sweden

[33] Hosp Papa Giovanni XXIII, Pediat Oncol, I-24127 Bergamo, Italy

[34] Hosp Papa Giovanni XXIII, Pediat Hepatol Gastroenterol & Transplantat, I-24127 Bergamo, Italy

[35] Univ Paris Saclay, Hop Bicetre, AP HP, Pediat Hepatol,Natl Ctr Biliary Atresia, F-94270 Le Kremlin Bicetre, France

[36] Hosp Univ La Paz, La Paz Inst Biomed Res, IdiPAZ, Madrid 28046, Spain

来源：

CHILDREN-BASEL | 2021年 / 8卷 / 08期

关键词：

PTLD; post-transplant lymphoproliferative disorder; pediatric; solid organ transplantation; immunosuppression; Epstein-Barr virus; EPSTEIN-BARR-VIRUS; LOW-DOSE CHEMOTHERAPY; ADAPTED TREATMENT; VIRAL LOAD; T-CELLS; DISEASE; EBV; RECIPIENTS; RITUXIMAB; PTLD;

D O I：

10.3390/children8080661

中图分类号：

R72 [儿科学];

学科分类号：

100202 ;

摘要：

(1) Background: Post-transplant lymphoproliferative disease (PTLD) is a significant complication of solid organ transplantation (SOT). However, there is lack of consensus in PTLD management. Our aim was to establish a present benchmark for comparison between international centers and between various organ transplant systems and modalities; (2) Methods: A cross-sectional questionnaire of relevant PTLD practices in pediatric transplantation was sent to multidisciplinary teams from 17 European center members of ERN TransplantChild to evaluate the centers' approach strategies for diagnosis and treatment and how current practices impact a cross-sectional series of PTLD cases; (3) Results: A total of 34 SOT programs from 13 European centers participated. The decision to start preemptive treatment and its guidance was based on both EBV viremia monitoring plus additional laboratory methods and clinical assessment (61%). Among treatment modalities the most common initial practice at diagnosis was to reduce the immunosuppression (61%). A total of 126 PTLD cases were reported during the period 2012-2016. According to their histopathological classification, monomorphic lesions were the most frequent (46%). Graft rejection after PTLD remission was 33%. Of the total cases diagnosed with PTLD, 88% survived; (4) Conclusions: There is still no consensus on prevention and treatment of PTLD, which implies the need to generate evidence. This might successively allow the development of clinical guidelines.

引用

页数：14

共 47 条

[1] Post-transplant lymphoproliferative disorder after solid-organ transplant in children [J].

Absalon, Michael J. ;

Khoury, Ruby A. ;

Phillips, Christine L. .

SEMINARS IN PEDIATRIC SURGERY, 2017, 26 (04) :257-266

[2] Post-transplant lymphoproliferative disorders with naso- and oropharyngeal manifestation [J].

Akbas, Ayla ;

Tiede, Christina ;

Lemound, Juliana ;

Maecker-Kolhoff, Britta ;

Kreipe, Hans ;

Hussein, Kais .

TRANSPLANT INTERNATIONAL, 2015, 28 (11) :1299-1307

[3] Post-transplant lymphoproliferative disorders, Epstein-Barr virus infection, and disease in solid organ transplantation: Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice [J].

Allen, Upton D. ;

Preiksaitis, Jutta K. .

CLINICAL TRANSPLANTATION, 2019, 33 (09)

[4] Coinfection rates and clinical outcome data for cytomegalovirus and Epstein-Barr virus in post-transplant patients: A systematic review of the literature [J].

Anderson-Smits, Colin ;

Baker, Erin R. ;

Hirji, Ishan .

TRANSPLANT INFECTIOUS DISEASE, 2020, 22 (06)

[5] Current status of pediatric intestinal transplant in Europe [J].

Andres, Ane M. ;

Ramos, Esther ;

Hernandez, Francisco .

CURRENT OPINION IN ORGAN TRANSPLANTATION, 2020, 25 (02) :183-188

[6] Comparison of Clinical Features and Outcome of Pediatric Posttransplant Lymphoproliferative Disorder in Recipients of Small Bowel Allograft Versus Isolated Liver Transplantation [J].

Chiou, Fang Kuan ;

Beath, Sue V. ;

Morland, Bruce ;

Hartley, Jane ;

van Mourik, Indra ;

Abdel-Hady, Mona ;

Kelly, Deirdre A. ;

Sharif, Khalid ;

Gupte, Girish L. .

TRANSPLANTATION, 2020, 104 (07) :1429-1436

[7] Adapted Treatment of Epstein-Barr Virus Infection to Prevent Posttransplant Lymphoproliferative Disorder After Heart Transplantation [J].

Choquet, S. ;

Varnous, S. ;

Deback, C. ;

Golmard, J. L. ;

Leblond, V. .

AMERICAN JOURNAL OF TRANSPLANTATION, 2014, 14 (04) :857-866

[8] Infusion of autologous Epstein-Barr virus (EBV) -: specific cytotoxic T cells for prevention of EBV-related lymphoproliferative disorder in solid organ transplant recipients with evidence of active virus replication [J].

Comoli, P ;

Labirio, M ;

Basso, S ;

Baldanti, F ;

Grossi, P ;

Furione, M ;

Viganò, M ;

Fiocchi, R ;

Rossi, G ;

Ginevri, F ;

Gridelli, B ;

Moretta, A ;

Montagna, D ;

Locatelli, F ;

Gerna, G ;

Comoli, P .

BLOOD, 2002, 99 (07) :2592-2598

[9] Management of post-transplant lymphoproliferative disorders [J].

DeStefano, Christin B. ;

Desai, Sanjal H. ;

Shenoy, Aarthi G. ;

Catlett, Joseph P. .

BRITISH JOURNAL OF HAEMATOLOGY, 2018, 182 (03) :330-343

[10] Post-transplant lymphoproliferative disorders [J].

Dharnidharka, Vikas R. ;

Webster, Angela C. ;

Martinez, Olivia M. ;

Preiksaitis, Jutta K. ;

Leblond, Veronique ;

Choquet, Sylvain .

NATURE REVIEWS DISEASE PRIMERS, 2016, 2

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