Epstein-Barr virus-associated post-transplant lymphoproliferative disorders: beyond chemotherapy treatment.

Content Provider	Europe PMC
Author	Shahid, Sanam Prockop, Susan E.
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.
Related Links	https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC8415721&blobtype=pdf
Journal	Cancer Drug Resistance [Cancer Drug Resist]
Volume Number	4
DOI	10.20517/cdr.2021.34
PubMed Central reference number	PMC8415721
Issue Number	3
PubMed reference number	34485854
e-ISSN	2578532X
Language	English
Publisher	OAE Publishing Inc.
Publisher Date	2021-06-06
Access Restriction	Open
Rights License	© The Author(s) 2021. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. © The Author(s) 2021.
Subject Keyword	Post-transplant lymphoproliferative disease PTLD Epstein-Barr virus EBV rituximab CD20 monoclonal antibody immunotherapy chemoimmunotherapy EBV-specific cytotoxic T lymphocytes EBV CTLs
Content Type	Text
Resource Type	Article
Subject	Pharmacology (medical) Cancer Research