Epstein-Barr virus-associated post-transplant lymphoproliferative disorders: Beyond chemotherapy treatment Review
| Authors: | Shahid, S.; Prockop, S. E. |
| Review Title: | Epstein-Barr virus-associated post-transplant lymphoproliferative disorders: Beyond chemotherapy treatment |
| Abstract: | Post-transplant lymphoproliferative disorder (PTLD) is a rare but life-threatening complication of both allogeneic solid organ (SOT) and hematopoietic cell transplantation (HCT). The histology of PTLD ranges from benign polyclonal lymphoproliferation to a lesion indistinguishable from classic monoclonal lymphoma. Most commonly, PTLDs are Epstein-Barr virus (EBV) positive and result from loss of immune surveillance over EBV. Treatment for PTLD differs from the treatment for typical non-Hodgkin lymphoma because prognostic factors are different, resistance to treatment is unique, and there are specific concerns for organ toxicity. While recipients of HCT have a limited time during which they are at risk for this complication, recipients of SOT have a lifelong requirement for immunosuppression, so approaches that limit compromising or help restore immune surveillance are of high interest. Furthermore, while EBV-positive and EBV-negative PTLDs are not intrinsically resistant to chemotherapy, the poor tolerance of chemotherapy in the post-transplant setting makes it essential to minimize potential treatment-related toxicities and explore alternative treatment algorithms. Therefore, reduced-toxicity approaches such as single-agent CD20 monoclonal antibodies or bortezomib, reduced dosing of standard chemotherapeutic agents, and non-chemotherapy-based approaches such as cytotoxic T cells have all been explored. Here, we review the chemotherapy and non-chemotherapy treatment landscape for PTLD. |
| Keywords: | rituximab; transplantation; immunotherapy; nasopharyngeal carcinoma; adoptive immunotherapy; antitumor-activity; stem-cell; organ transplant recipients; cytotoxic t-lymphocytes; ebv; chemoimmunotherapy; viral-infections; epstein-barr virus; cd20 monoclonal antibody; anti-cd20 antibody; ptld; post-transplant lymphoproliferative disease; ebv-specific cytotoxic t lymphocytes; ebv ctls; disease ptld; adenovirus infections |
| Journal Title: | Cancer Drug Resistance |
| Volume: | 4 |
| Issue: | 3 |
| ISSN: | 2578-532X |
| Publisher: | Unknown |
| Date Published: | 2021-01-01 |
| Start Page: | 646 |
| End Page: | 664 |
| Language: | English |
| ACCESSION: | WOS:000849617700009 |
| DOI: | 10.20517/cdr.2021.34 |
| PROVIDER: | wos |
| PMCID: | PMC8415721 |
| PUBMED: | 34485854 |
| Notes: | Review -- Source: Wos |
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