EBV-Associated Post-Transplant Lymphoproliferative Disease (PTLD) in Allogeneic Transplantation

Cutini I, Peruzzi B, Caporale R, Nozzoli C, Gozzini A, Innocenti C, Boncompagni R, Fani A, Saccardi R
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Abstract

Post-Transplant Lymphoproliferative Disease (PTLD) following both Solid Organ Transplantation (SOT) and Hematopoietic Stem Cell Transplantation (HSCT) is a rare life-threatening complication. The majority of PLTDs are associated to Epstein Bar Virus (EBV) [1] reactivation, usually in the early phase [2] after transplant, when the patient is severely immunocompromised and is unable to control virus replication [3]. Despite the mortality of EBV-associated PTLD has been reduced over the years, the different histological patterns of its presentation, ranging from indolent to high grade B cell lymphoma, still play a role in the outcome. Herein, we report the case of a 60-years-old man diagnosed with acute myeloid leukemia who underwent allogeneic transplantation and developed a fatal Hemophagocytic Histiocytosis (HLH) secondary to an aggressive EBV-associated PTLD, not responding to a rituximab-based treatment.
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同种异体移植中ebv相关的移植后淋巴增生性疾病(PTLD)
实体器官移植(SOT)和造血干细胞移植(HSCT)后的移植后淋巴增生性疾病(PTLD)是一种罕见的危及生命的并发症。大多数pltd与eb病毒(EBV)[1]再激活有关,通常发生在移植后的早期阶段,此时患者严重免疫功能低下,无法控制病毒复制[3]。尽管ebv相关PTLD的死亡率多年来一直在降低,但其表现的不同组织学模式,从惰性到高级别B细胞淋巴瘤,仍然在结果中发挥作用。在此,我们报告了一例60岁的男性诊断为急性髓性白血病,他接受了同种异体移植,并发了致命性的噬血细胞组织细胞增生症(HLH),继发于侵袭性ebv相关的PTLD,利妥昔单抗治疗无效。
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