Emily Work, Dipankar Gupta, William B Slayton, John Rees, John-Anthony Coppola, Robert Seifert, Mark S Bleiweis, Jeffrey P Jacobs, Giles Peek, Joseph Philip, Alan Brock, Jose Hernandez Rivera, Kevin Sullivan, Sukumar Suguna Narasimhulu
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引用次数: 0
摘要
爱泼斯坦-巴氏病毒（EBV）是一种无处不在的疱疹病毒，与移植后淋巴组织增生性疾病（PTLD）有关。通常的治疗方法包括减少或停止免疫抑制，在某些情况下还包括利妥昔单抗在内的化疗。然而，如果 PTLD 对利妥昔单抗难治，可使用的疗法也很有限。有几项临床试验研究了在利妥昔单抗难治性患者中使用 EBV 引导的 T 细胞，但有关反应的数据很少，也没有定论。在本文中，我们描述了一名在心脏移植（OHT）后对利妥昔单抗难治的EBV-PTLD患者，该患者需要接受EBV导向的T细胞治疗。本文旨在强调PTLD独特而凶险的临床表现和进展，以及利用EBV引导的T细胞疗法进行治疗和相关陷阱。
Epstein Barr virus-directed T-cell therapy for refractory EBV-PTLD in a toddler post Orthotopic heart transplantation.
Epstein-Barr Virus (EBV) is a ubiquitous herpes type virus that is associated with post-transplant lymphoproliferative disorder (PTLD). Usual management includes reduction or cessation of immunosuppression and in some cases chemotherapy including rituximab. However, limited therapies are available if PTLD is refractory to rituximab. Several clinical trials have investigated the use of EBV-directed T cells in rituximab-refractory patients; however, data regarding response is scarce and inconclusive. Herein, we describe a patient with EBV-PTLD refractory to rituximab after orthotopic heart transplantation (OHT) requiring EBV-directed T-cell therapy. This article aims to highlight the unique and aggressive clinical presentation and progression of PTLD with utilization of EBV-directed T-cell therapy for management and associated pitfalls.
期刊介绍：
The aim of Pediatric Transplantation is to publish original articles of the highest quality on clinical experience and basic research in transplantation of tissues and solid organs in infants, children and adolescents. The journal seeks to disseminate the latest information widely to all individuals involved in kidney, liver, heart, lung, intestine and stem cell (bone-marrow) transplantation. In addition, the journal publishes focused reviews on topics relevant to pediatric transplantation as well as timely editorial comment on controversial issues.
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