TY - JOUR
T1 - Diagnosis and treatment of posttransplantation lymphoproliferative disease after hematopoietic stem cell transplantation
AU - Wagner, Hans Joachim
AU - Rooney, Cliona M.
AU - Heslop, Helen
PY - 2002
Y1 - 2002
N2 - Uncontrolled expansion of donor-derived Epstein-Barr virus (EBV)-infected B cells has become a significant problem in recipients of allogeneic hematopoietic stem cell transplantations. Major risk factors for the early development of posttransplantation lymphoproliferative disease include the use of unrelated or HLA-mismatched related donors, selective T-cell depletion of donor marrow, and the use of antithymocyte globulin or monoclonal anti-T-cell antibodies for the prophylaxis and treatment of acute graft-versus-host disease. Over the past few years, the administration of in vitro-generated EBV-specific cytotoxic T cells or anti-B-cell monoclonal antibodies has provided effective options for the prophylaxis or treatment of posttransplantation lymphoproliferative disease. Advances in quantitative polymerase chain reaction-based assays allow both the precise measurement of EBV load in peripheral blood samples and the identification of high-risk patients for early initiation of therapy. A major remaining challenge is to assess the significance of an elevated EBV load posttransplantation and to determine the indications for preemptive treatment.
AB - Uncontrolled expansion of donor-derived Epstein-Barr virus (EBV)-infected B cells has become a significant problem in recipients of allogeneic hematopoietic stem cell transplantations. Major risk factors for the early development of posttransplantation lymphoproliferative disease include the use of unrelated or HLA-mismatched related donors, selective T-cell depletion of donor marrow, and the use of antithymocyte globulin or monoclonal anti-T-cell antibodies for the prophylaxis and treatment of acute graft-versus-host disease. Over the past few years, the administration of in vitro-generated EBV-specific cytotoxic T cells or anti-B-cell monoclonal antibodies has provided effective options for the prophylaxis or treatment of posttransplantation lymphoproliferative disease. Advances in quantitative polymerase chain reaction-based assays allow both the precise measurement of EBV load in peripheral blood samples and the identification of high-risk patients for early initiation of therapy. A major remaining challenge is to assess the significance of an elevated EBV load posttransplantation and to determine the indications for preemptive treatment.
KW - Anti-B-cell antibodies
KW - Cytotoxic T cells
KW - Epstein-Barr virus
KW - Hematopoietic stem cell transplantation
KW - Immunotherapy
KW - Posttransplantation lymphoproliferative disease
UR - http://www.scopus.com/inward/record.url?scp=0036167201&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0036167201&partnerID=8YFLogxK
U2 - 10.1053/bbmt.2002.v8.pm11846351
DO - 10.1053/bbmt.2002.v8.pm11846351
M3 - Article
C2 - 11846351
AN - SCOPUS:0036167201
VL - 8
SP - 1
EP - 8
JO - Biology of Blood and Marrow Transplantation
JF - Biology of Blood and Marrow Transplantation
SN - 1083-8791
IS - 1
ER -