Post-Transplant Lymphoproliferative Disease (PTLD) after Allogeneic Hematopoietic Stem Cell Transplantation: Biology and Treatment Options
Post-transplant lymphoproliferative disease (PTLD) is a serious complication occurring as a consequence of immunosuppression in the setting of allogeneic hematopoietic stem cell transplantation (alloHSCT) or solid organ transplantation (SOT). The majority of PTLD arises from B-cells, and Epstein–Bar...
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MDPI AG
2022-12-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/24/7542 |
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| author | Michele Clerico Irene Dogliotti Andrea Aroldi Chiara Consoli Luisa Giaccone Benedetto Bruno Federica Cavallo |
| author_facet | Michele Clerico Irene Dogliotti Andrea Aroldi Chiara Consoli Luisa Giaccone Benedetto Bruno Federica Cavallo |
| author_sort | Michele Clerico |
| collection | DOAJ |
| description | Post-transplant lymphoproliferative disease (PTLD) is a serious complication occurring as a consequence of immunosuppression in the setting of allogeneic hematopoietic stem cell transplantation (alloHSCT) or solid organ transplantation (SOT). The majority of PTLD arises from B-cells, and Epstein–Barr virus (EBV) infection is present in 60–80% of the cases, revealing the central role played by the latent infection in the pathogenesis of the disease. Therefore, EBV serological status is considered the most important risk factor associated with PTLDs, together with the depth of T-cell immunosuppression pre- and post-transplant. However, despite the advances in pathogenesis understanding and the introduction of novel treatment options, PTLD arising after alloHSCT remains a particularly challenging disease, and there is a need for consensus on how to treat rituximab-refractory cases. This review aims to explore the pathogenesis, risk factors, and treatment options of PTLD in the alloHSCT setting, finally focusing on adoptive immunotherapy options, namely EBV-specific cytotoxic T-lymphocytes (EBV-CTL) and chimeric antigen receptor T-cells (CAR T). |
| first_indexed | 2024-03-09T16:15:56Z |
| format | Article |
| id | doaj.art-8c65aab5c39049418f5e894bd095c825 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T16:15:56Z |
| publishDate | 2022-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-8c65aab5c39049418f5e894bd095c8252023-11-24T15:47:25ZengMDPI AGJournal of Clinical Medicine2077-03832022-12-011124754210.3390/jcm11247542Post-Transplant Lymphoproliferative Disease (PTLD) after Allogeneic Hematopoietic Stem Cell Transplantation: Biology and Treatment OptionsMichele Clerico0Irene Dogliotti1Andrea Aroldi2Chiara Consoli3Luisa Giaccone4Benedetto Bruno5Federica Cavallo6Division of Hematology, Department of Molecular Biotechnology and Health Sciences, A.O.U. Città della Salute e della Scienza di Torino, University of Torino, 10126 Turin, ItalyStem Cell Transplant Unit, A.O.U. Città della Salute e della Scienza di Torino, 10126 Turin, ItalyDivision of Hematology, Bone Marrow Transplant Unit, University of Milan-Bicocca, Ospedale San Gerardo, 20900 Monza, ItalyDivision of Hematology, Department of Molecular Biotechnology and Health Sciences, A.O.U. Città della Salute e della Scienza di Torino, University of Torino, 10126 Turin, ItalyStem Cell Transplant Unit, A.O.U. Città della Salute e della Scienza di Torino, 10126 Turin, ItalyDivision of Hematology, Department of Molecular Biotechnology and Health Sciences, A.O.U. Città della Salute e della Scienza di Torino, University of Torino, 10126 Turin, ItalyDivision of Hematology, Department of Molecular Biotechnology and Health Sciences, A.O.U. Città della Salute e della Scienza di Torino, University of Torino, 10126 Turin, ItalyPost-transplant lymphoproliferative disease (PTLD) is a serious complication occurring as a consequence of immunosuppression in the setting of allogeneic hematopoietic stem cell transplantation (alloHSCT) or solid organ transplantation (SOT). The majority of PTLD arises from B-cells, and Epstein–Barr virus (EBV) infection is present in 60–80% of the cases, revealing the central role played by the latent infection in the pathogenesis of the disease. Therefore, EBV serological status is considered the most important risk factor associated with PTLDs, together with the depth of T-cell immunosuppression pre- and post-transplant. However, despite the advances in pathogenesis understanding and the introduction of novel treatment options, PTLD arising after alloHSCT remains a particularly challenging disease, and there is a need for consensus on how to treat rituximab-refractory cases. This review aims to explore the pathogenesis, risk factors, and treatment options of PTLD in the alloHSCT setting, finally focusing on adoptive immunotherapy options, namely EBV-specific cytotoxic T-lymphocytes (EBV-CTL) and chimeric antigen receptor T-cells (CAR T).https://www.mdpi.com/2077-0383/11/24/7542post-transplant lymphoproliferative disease (PTLD)allogeneic hematopoietic stem cell transplantation (alloHSCT)Epstein–Barr virus (EBV) |
| spellingShingle | Michele Clerico Irene Dogliotti Andrea Aroldi Chiara Consoli Luisa Giaccone Benedetto Bruno Federica Cavallo Post-Transplant Lymphoproliferative Disease (PTLD) after Allogeneic Hematopoietic Stem Cell Transplantation: Biology and Treatment Options Journal of Clinical Medicine post-transplant lymphoproliferative disease (PTLD) allogeneic hematopoietic stem cell transplantation (alloHSCT) Epstein–Barr virus (EBV) |
| title | Post-Transplant Lymphoproliferative Disease (PTLD) after Allogeneic Hematopoietic Stem Cell Transplantation: Biology and Treatment Options |
| title_full | Post-Transplant Lymphoproliferative Disease (PTLD) after Allogeneic Hematopoietic Stem Cell Transplantation: Biology and Treatment Options |
| title_fullStr | Post-Transplant Lymphoproliferative Disease (PTLD) after Allogeneic Hematopoietic Stem Cell Transplantation: Biology and Treatment Options |
| title_full_unstemmed | Post-Transplant Lymphoproliferative Disease (PTLD) after Allogeneic Hematopoietic Stem Cell Transplantation: Biology and Treatment Options |
| title_short | Post-Transplant Lymphoproliferative Disease (PTLD) after Allogeneic Hematopoietic Stem Cell Transplantation: Biology and Treatment Options |
| title_sort | post transplant lymphoproliferative disease ptld after allogeneic hematopoietic stem cell transplantation biology and treatment options |
| topic | post-transplant lymphoproliferative disease (PTLD) allogeneic hematopoietic stem cell transplantation (alloHSCT) Epstein–Barr virus (EBV) |
| url | https://www.mdpi.com/2077-0383/11/24/7542 |
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