Diagnosis and treatment of posttransplantation lymphoproliferative disease after hematopoietic stem cell transplantation.
Diagnosis and treatment of posttransplantation lymphoproliferative disease after hematopoietic stem cell transplantation.
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DOI：
10.1053/bbmt.2002.v8.pm11846351
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发表时间：
2002
期刊：
影响因子：
--
通讯作者：
H. Wagner;C. Rooney;H. Heslop
中科院分区：
文献类型：
--
作者：
H. Wagner;C. Rooney;H. Heslop
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.
