Recent advances in the risk factors, diagnosis and management of Epstein-Barr virus post-transplant lymphoproliferative disease

Paibel Aguayo-Hiraldo, Reuben Arasaratnam, Rayne H. Rouce

Research output: Contribution to journalReview article

2 Citations (Scopus)

Abstract

Fifty years after the first reports of Epstein-Barr virus (EBV)-associated endemic Burkitt's lymphoma, EBV has emerged as the third most prevalent oncogenic virus worldwide. EBV infection is associated with various malignancies including Hodgkin and non-Hodgkin lymphoma, NK/T-cell lymphoma and nasopharyngeal carcinoma. Despite the highly specific immunologic control in the immunocompetent host, EBV can cause severe complications in the immunocompromised host (namely, post-transplant lymphoproliferative disease). This is particularly a problem in patients with delayed immune reconstitution post-hematopoietic stem cell transplant or solid organ transplant. Despite advances in diagnostic techniques and treatment algorithms allowing earlier identification and treatment of patients at highest risk, mortality rates remain as high as 90% if not treated early. The cornerstones of treatment include reduction in immunosuppression and in vivo B cell depletion with an anti-CD20 monoclonal antibody. However, these treatment modalities are not always feasible due to graft rejection, emergence of graft vs. host disease, and toxicity. Newer treatment modalities include the use of adoptive T cell therapy, which has shown promising results in various EBV-related malignancies. In this article we will review recent advances in risk factors, diagnosis and management of EBV-associated malignancies, particularly post-transplant lymphoproliferative disease. We will also discuss new and innovative treatment options including adoptive T cell therapy as well as management of special situations such as chronic active EBV and EBV-associated hemophagocytic lymphohistiocytosis.

Original languageEnglish (US)
Pages (from-to)31-40
Number of pages10
JournalBoletin Medico del Hospital Infantil de Mexico
Volume73
Issue number1
DOIs
StatePublished - Jan 1 2016

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Risk Management
Human Herpesvirus 4
Transplants
Cell- and Tissue-Based Therapy
Therapeutics
T-Lymphocytes
Hemophagocytic Lymphohistiocytosis
Neoplasms
Oncogenic Viruses
Epstein-Barr Virus Infections
Burkitt Lymphoma
T-Cell Lymphoma
Graft Rejection
Immunocompromised Host
Hematopoietic Stem Cells
Hodgkin Disease
Natural Killer Cells
Non-Hodgkin's Lymphoma
Immunosuppression
B-Lymphocytes

Keywords

  • Epstein-Barr virus
  • Hematopoietic stem cell transplant
  • Immunotherapy
  • Post-transplant lymphoproliferative disease
  • Solid organ transplant

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Recent advances in the risk factors, diagnosis and management of Epstein-Barr virus post-transplant lymphoproliferative disease. / Aguayo-Hiraldo, Paibel; Arasaratnam, Reuben; Rouce, Rayne H.

In: Boletin Medico del Hospital Infantil de Mexico, Vol. 73, No. 1, 01.01.2016, p. 31-40.

Research output: Contribution to journalReview article

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