Post-transplant lymphoproliferative disorder in children: Incidence, prognosis, and treatment options

被引：29
作者：
Faye A. [1 ,2 ]
Vilmer E. [1 ]
机构：
[1] Service d'Hémato-Immunologie, Hôpital Robert Debré, Paris
[2] Service d'Hémato-Immunologie, Hôpital Robert Debré, Paris, 75019
来源：
Pediatric Drugs | 2005年 / 7卷 / 1期
关键词：
Hematopoietic Stem Cell Transplantation; Solid Organ Transplantation; Acute GVHD; Foscarnet; Solid Organ Transplantation Recipient;
D O I：
10.2165/00148581-200507010-00005
中图分类号：
学科分类号：
摘要：
Post-transplant lymphoproliferative disorder (PTLD) after solid organ or hematopoietic stem cell transplantation in children is a serious complication that has been responsible for high mortality rates over recent years. PTLDs are part of a clinically and histologically heterogeneous group of B-lymphocyte proliferations mostly induced by Epstein-Barr virus (EBV) in a context of immunosuppression. Major risk factors for PTLDs in solid organ transplantation are the EBV serostatus mismatch and the intensity, duration, and type of immunosuppression. T-cell depletion and the HLA-mismatched donor and recipient are the main risk factors following hematopoietic stem cell transplantation. For a long time, the only safe and effective therapeutic approach to PTLD was reduction of immunosuppression, with a risk of graft rejection. Based on a better knowledge of the pathophysiology and risk factors for PTLD, preventive and pre-emptive strategies have been recently proposed to control PTLD. New treatment modalities, such as anti-B-cell antibodies, cytokine inhibitor therapy, or anti-EBV cytotoxic T lymphocytes are promising and may improve the outcome of PTLD. These therapeutic approaches need to be further evaluated, especially in the context of pre-emptive strategies adapted to predictive markers of EBV-induced PTLD. © 2005 Adis Data Information BV. All rights reserved.
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页码：55 / 65
页数：10
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