Post-transplantation lymphoproliferative

BMT, bone marrow transplantation NHL, non-Hodgkin lymphoma PT-LPD, post-transplantation lymphoprolife-rative disorders RSV, respiratory syncytial virus Tx, transplantation. 

Faro, A., Interferon-alpha and its effects on post-transplant lymphoproliferative disorders. Springer Semin Immunopathol, 1998. 20(3 ) 425-36. 

Capello D, Rossi D, Gaidano G. Post-transplant lymphoproliferative disorders molecular basis of disease histogenesis and pathogenesis. Hematol Oncol 2005 23 61-7. 

IMATINIB CICLOSPORIN t plasma concentrations of cidosporin, with risk of nephrotoxicity, myelosuppression, neurotoxicity and excessive immunosuppression, with risk of infection and post-transplant lymphoproliferative disease Inhibition of metabolism of cidosporin Monitor plasma cidosporin levels to prevent toxicity... 

CICLOSPORIN AZOLES - ITRACONAZOLE, KETOCONAZOLE, VORICONAZOLE t plasma concentrations of ciclosporin, with risk of nephrotoxicity, myelosuppression, neurotoxicity, excessive immunosuppression, with risk of infection and post-transplant lymphoproliferative disease Inhibition of CYP3A4-mediated metabolism of ciclosporin these inhibitors vary in potency. Ketoconazole and itraconazole are classified as potent inhibitors. Effect not clinically relevant with fluconazole Avoid co-administration with itraconazole or ketoconazole. Consider alternative azole but need to monitor plasma ciclosporin levels to prevent toxicity... 

High-dose chemotherapy with cyclophosphamide, vincristine, prednisolone, and intrathecal methotrexate given for post-transplant lymphoproliferative disease was suggested to have favored the occurrence of acute ciclosporin neurotoxicity (headache, fever, seizures, and visual agnosia) in a 9-year-old cardiac transplant patient (239). Ciclosporin serum concentrations were normal and a further similar episode occurred on ciclosporin readministration. 

Faro A, Kurland G, Michaels MG, et al. Interferon-a affects the immune response in post-transplant lymphoproliferative disorder. Am J Respir Grit Care Med 1996 153 1442-7. 

Hsieh WS, Lemas MV, Ambinder RF. The biology of Epstein-Barr virus in post-transplant lymphoprolifer-ative disease. Transpl Infect Dis 1999 1 204-12. 

Malignancies Solid tumors, post-transplant lymphoproliferative disorders... 

Berney T, Dehs S, Kato T, et al. Successful treatment of post-transplant lymphoproliferative disease with prolonged rituximab treatment in intestinal transplant recipients. Transplantation 2002 74 1000-1006. 

HODGKIN-LIKE POST-TRANSPLANT LYMPHOPROLIFERATIVE DISORDER (HL-PTLD)... 

FIGURE 5.21 Hodgkin-like post-transplant lymphoproliferative disorder. 

POST-TRANSPLANTATION LYMPHOPROLIFERATIVE DISORDERS Following organ transplantation and associated immunosuppression, a range of post-transplantation lymphoproliferative disorders can develop. Histologic,... 

Type III latency, characterized by the expression of all EBNAs and LMPs. This transcriptional pattern is characteristic for the acnite phase of infectious mono-nucdeosis but also found to be associated with post transplant lymphoproliferative disorders. 

Other proliferative diseases, for example, gastric carcinoma, breast cancer, T cell lymphoma, follicular dendritic cell tumors Immunosuppressed graft recipients post-transplant lymphoproliferative disease AIDS patients Burkitt s and Hodgkin s lymphomas, CNS lymphomas, leiosarcomas, oral hairy leukoplakia Kaposi s sarcoma, primary effusion lymphoma, multicentric Castleman s disease... 

Using the same design in patients who received kidney transplants, patient and graft survival were similar in the two groups, with superior renal function in patients treated with belatacept [5 "]. However, in this study, there were a higher incidence and grade of graft rejection and post-transplant lymphoproliferative disorders in those who received belatacept. 

In a study of alemtuzumab for the treatment of acute rejection in 15 kidney transplant recipients, the rates of malignancies in alemtuzumab-treated patients were not increased during 12 years follow-up in particular, no patients treated with alemtuzumab for acute rejection developed post-transplantation lymphoproliferative disorders [148 ]. 

Abrahamian G. Intestinal perforation associated with rituximab therapy tor post-transplant lymphoproliferative disorder after liver transplantation. Cancer Chemother Pharmacol 2009 64(4) ... 

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