The IPTA Nashville consensus conference on post-transplant lymphoproliferative disorders after solid organ transplantation in children: IV-consensus guidelines for the management of post-transplant lymphoproliferative disorders in children and adolescents
Corresponding Author
Upton D. Allen
Division of Infectious Diseases, Department of Paediatrics, Transplant and Regenerative Medicine Center, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
Correspondence
Upton D. Allen, Division of Infectious Diseases, Department of Pediatrics, Transplant and Regenerative Medicine Centre, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.
Email: [email protected]
Search for more papers by this authorArnaud G. L'Huillier
Pediatric Infectious Diseases Unit and Laboratory of Virology, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
Search for more papers by this authorCatherine M. Bollard
Center for Cancer and Immunology Research, Children's National Hospital, The George Washington University, Washington, District of Columbia, USA
Search for more papers by this authorThomas G. Gross
Center for Cancer and Blood Diseases, Children's Hospital Colorado, Aurora, Colorado, USA
Search for more papers by this authorRobert J. Hayashi
Division of Pediatric Hematology/Oncology, St. Louis Children's Hospital, Washington University School of Medicine, St. Louis, Missouri, USA
Search for more papers by this authorBritta Höcker
Department of Pediatrics I, Medical Faculty, University Children's Hospital, Heidelberg University, Heidelberg, Germany
Search for more papers by this authorBritta Maecker-Kolhoff
Hannover Medical School, Pediatric Hematology and Oncology, Hannover, Germany
Search for more papers by this authorStephen D. Marks
Department of Paediatric Nephrology, Great Ormond Street Hospital for Children NHS Foundation Trust, NIHR Great Ormond Street Hospital Biomedical Research Centre, London, UK
Search for more papers by this authorGeorge Vincent Mazariegos
Hillman Center for Pediatric Transplantation, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
Search for more papers by this authorFrancoise Smets
Pediatric Gastroenterology and Hepatology, Cliniques Universitaires Saint-Luc, UCLouvain, Brussels, Belgium
Search for more papers by this authorRalf U. Trappe
Department of Hematology and Oncology, DIAKO Ev. Diakonie-Krankenhaus Bremen, Bremen, Germany
Department of Internal Medicine II: Hematology and Oncology, University Medical Centre Schleswig-Holstein, Kiel, Germany
Search for more papers by this authorGary Visner
Division of Pulmonary Medicine, Boston Children's Hospital/Harvard Medical School, Boston, Massachusetts, USA
Search for more papers by this authorRichard E. Chinnock
Loma Linda University Children's Hospital, Loma Linda, California, USA
Search for more papers by this authorPatrizia Comoli
Cell Factory & Pediatric Hematology/Oncology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
Search for more papers by this authorLara Danziger-Isakov
Division of Infectious Disease, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio, USA
Search for more papers by this authorDaniel E. Dulek
Division of Pediatric Infectious Diseases, Monroe Carell Junior Children's Hospital at Vanderbilt and Vanderbilt University Medical Center, Nashville, Tennessee, USA
Search for more papers by this authorAnne I. Dipchand
Department of Paediatrics, Labatt Family Heart Centre, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
Search for more papers by this authorJudith A. Ferry
Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, USA
Search for more papers by this authorOlivia M. Martinez
Department of Surgery and Program in Immunology, Stanford University School of Medicine, Stanford, California, USA
Search for more papers by this authorDiana M. Metes
Thomas E. Starzl Transplantation Institute, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
Search for more papers by this authorMarian G. Michaels
Division of Pediatric Infectious Diseases, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
Search for more papers by this authorJutta Preiksaitis
Division of Infectious Diseases, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
Search for more papers by this authorJames E. Squires
Division of Gastroenterology, Hepatology and Nutrition, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
Search for more papers by this authorSteven H. Swerdlow
Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
Search for more papers by this authorJames D. Wilkinson
Department of Pediatrics, Vanderbilt School of Medicine, Nashville, Tennessee, USA
Search for more papers by this authorVikas R. Dharnidharka
Division of Pediatric Nephrology, Hypertension & Apheresis, Department of Pediatrics, Washington University School of Medicine and St. Louis Children's Hospital, St. Louis, Missouri, USA
Search for more papers by this authorMichael Green
Division of Pediatric Infectious Diseases, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
Search for more papers by this authorSteven A. Webber
Department of Pediatrics, Vanderbilt School of Medicine, Nashville, Tennessee, USA
Search for more papers by this authorCarlos O. Esquivel
Stanford University School of Medicine, Stanford, California, USA
Search for more papers by this authorCorresponding Author
Upton D. Allen
Division of Infectious Diseases, Department of Paediatrics, Transplant and Regenerative Medicine Center, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
Correspondence
Upton D. Allen, Division of Infectious Diseases, Department of Pediatrics, Transplant and Regenerative Medicine Centre, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.
Email: [email protected]
Search for more papers by this authorArnaud G. L'Huillier
Pediatric Infectious Diseases Unit and Laboratory of Virology, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
Search for more papers by this authorCatherine M. Bollard
Center for Cancer and Immunology Research, Children's National Hospital, The George Washington University, Washington, District of Columbia, USA
Search for more papers by this authorThomas G. Gross
Center for Cancer and Blood Diseases, Children's Hospital Colorado, Aurora, Colorado, USA
Search for more papers by this authorRobert J. Hayashi
Division of Pediatric Hematology/Oncology, St. Louis Children's Hospital, Washington University School of Medicine, St. Louis, Missouri, USA
Search for more papers by this authorBritta Höcker
Department of Pediatrics I, Medical Faculty, University Children's Hospital, Heidelberg University, Heidelberg, Germany
Search for more papers by this authorBritta Maecker-Kolhoff
Hannover Medical School, Pediatric Hematology and Oncology, Hannover, Germany
Search for more papers by this authorStephen D. Marks
Department of Paediatric Nephrology, Great Ormond Street Hospital for Children NHS Foundation Trust, NIHR Great Ormond Street Hospital Biomedical Research Centre, London, UK
Search for more papers by this authorGeorge Vincent Mazariegos
Hillman Center for Pediatric Transplantation, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
Search for more papers by this authorFrancoise Smets
Pediatric Gastroenterology and Hepatology, Cliniques Universitaires Saint-Luc, UCLouvain, Brussels, Belgium
Search for more papers by this authorRalf U. Trappe
Department of Hematology and Oncology, DIAKO Ev. Diakonie-Krankenhaus Bremen, Bremen, Germany
Department of Internal Medicine II: Hematology and Oncology, University Medical Centre Schleswig-Holstein, Kiel, Germany
Search for more papers by this authorGary Visner
Division of Pulmonary Medicine, Boston Children's Hospital/Harvard Medical School, Boston, Massachusetts, USA
Search for more papers by this authorRichard E. Chinnock
Loma Linda University Children's Hospital, Loma Linda, California, USA
Search for more papers by this authorPatrizia Comoli
Cell Factory & Pediatric Hematology/Oncology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
Search for more papers by this authorLara Danziger-Isakov
Division of Infectious Disease, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio, USA
Search for more papers by this authorDaniel E. Dulek
Division of Pediatric Infectious Diseases, Monroe Carell Junior Children's Hospital at Vanderbilt and Vanderbilt University Medical Center, Nashville, Tennessee, USA
Search for more papers by this authorAnne I. Dipchand
Department of Paediatrics, Labatt Family Heart Centre, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
Search for more papers by this authorJudith A. Ferry
Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, USA
Search for more papers by this authorOlivia M. Martinez
Department of Surgery and Program in Immunology, Stanford University School of Medicine, Stanford, California, USA
Search for more papers by this authorDiana M. Metes
Thomas E. Starzl Transplantation Institute, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
Search for more papers by this authorMarian G. Michaels
Division of Pediatric Infectious Diseases, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
Search for more papers by this authorJutta Preiksaitis
Division of Infectious Diseases, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
Search for more papers by this authorJames E. Squires
Division of Gastroenterology, Hepatology and Nutrition, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
Search for more papers by this authorSteven H. Swerdlow
Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
Search for more papers by this authorJames D. Wilkinson
Department of Pediatrics, Vanderbilt School of Medicine, Nashville, Tennessee, USA
Search for more papers by this authorVikas R. Dharnidharka
Division of Pediatric Nephrology, Hypertension & Apheresis, Department of Pediatrics, Washington University School of Medicine and St. Louis Children's Hospital, St. Louis, Missouri, USA
Search for more papers by this authorMichael Green
Division of Pediatric Infectious Diseases, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
Search for more papers by this authorSteven A. Webber
Department of Pediatrics, Vanderbilt School of Medicine, Nashville, Tennessee, USA
Search for more papers by this authorCarlos O. Esquivel
Stanford University School of Medicine, Stanford, California, USA
Search for more papers by this authorAbstract
The International Pediatric Transplant Association convened an expert consensus conference to assess current evidence and develop recommendations for various aspects of care relating to post-transplant lymphoproliferative disorders (PTLD) after pediatric solid organ transplantation. This report addresses the outcomes of deliberations by the PTLD Management Working Group. A strong recommendation was made for reduction in immunosuppression as the first step in management. Similarly, strong recommendations were made for the use of the anti-CD20 monoclonal antibody (rituximab) as was the case for chemotherapy in selected scenarios. In some scenarios, there is uncoupling of the strength of the recommendations from the available evidence in situations where such evidence is lacking but collective clinical experiences drive decision-making. Of note, there are no large, randomized phase III trials of any treatment for PTLD in the pediatric age group. Current gaps and future research priorities are highlighted.
Open Research
DATA AVAILABILITY STATEMENT
Data sharing is not applicable to this article as no new data were created or analyzed in this study.
REFERENCES
- 1Wilkinson JD, Allen U, Green M, et al. The IPTA Nashville consensus conference on post-transplant lymphoproliferative disorders after solid organ transplantation in children: I-methodology for the development of consensus practice guidelines. Pediatr Transplant. 2022: 28(1)e14333. doi:10.1111/petr.14333
- 2Guyatt GH, Oxman AD, Vist GE, et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ. 2008; 336(7650): 924-926.
- 3Andrews J, Guyatt G, Oxman AD, et al. GRADE guidelines: 14. Going from evidence to recommendations: the significance and presentation of recommendations. J Clin Epidemiol. 2013; 66(7): 719-725.
- 4Schunemann HJ, Jaeschke R, Cook DJ, et al. An official ATS statement: grading the quality of evidence and strength of recommendations in ATS guidelines and recommendations. Am J Respir Crit Care Med. 2006; 174(5): 605-614.
- 5Guyatt G, Oxman AD, Akl EA, et al. GRADE guidelines: 1. Introduction-GRADE evidence profiles and summary of findings tables. J Clin Epidemiol. 2011; 64(4): 383-394.
- 6Starzl TE, Nalesnik MA, Porter KA, et al. Reversibility of lymphomas and lymphoproliferative lesions developing under cyclosporin-steroid therapy. Lancet. 1984; 1(8377): 583-587.
- 7Cacciarelli TV, Green M, Jaffe R, et al. Management of posttransplant lymphoproliferative disease in pediatric liver transplant recipients receiving primary tacrolimus (FK506) therapy. Transplantation. 1998; 66(8): 1047-1052.
- 8Webber SA, Naftel DC, Fricker FJ, et al. Lymphoproliferative disorders after paediatric heart transplantation: a multi-institutional study. Lancet. 2006; 367(9506): 233-239. doi:10.1016/S0140-6736(06)67933-6
- 9Boyle GJ, Michaels MG, Webber SA, et al. Posttransplantation lymphoproliferative disorders in pediatric thoracic organ recipients. J Pediatr. 1997; 131(2): 309-313.
- 10Srivastava T, Zwick DL, Rothberg PG, Warady BA. Posttransplant lymphoproliferative disorder in pediatric renal transplantation. Pediatr Nephrol. 1999; 13(9): 748-754.
- 11Nathanson S, Debray D, Delarue A, Deschênes G. Long-term survival after post-transplant lymphoproliferative disease in children. Pediatr Nephrol. 2002; 17(8): 668-672.
- 12Jain A, Nalesnik M, Reyes J, et al. Posttransplant lymphoproliferative disorders in liver transplantation: a 20-year experience. Ann Surg. 2002; 236: 429-436; discussion 436-7.
- 13McDonald RA, Smith JM, Ho M, et al. Incidence of PTLD in pediatric renal transplant recipients receiving basiliximab, calcineurin inhibitor, sirolimus and steroids. Am J Transplant. 2008; 8(5): 984-989. doi:10.1111/j.1600-6143.2008.02167.x
- 14Schubert S, Abdul-Khaliq H, Lehmkuhl HB, et al. Diagnosis and treatment of post-transplantation lymphoproliferative disorder in pediatric heart transplant patients. Pediatr Transplant. 2009; 13(1): 54-62. doi:10.1111/j.1399-3046.2008.00969.x
- 15Uribe M, Hunter B, Alba A, et al. Posttransplant lymphoproliferative disorder in pediatric liver transplantation. Transplant Proc. 2009; 41(6): 2679-2681. doi:10.1016/j.transproceed.2009.06.132
- 16Nakanishi C, Kawagishi N, Sekiguchi S, et al. Post-transplantation lymphoproliferative disorder in living-donor liver transplantation: a single-center experience. Surg Today. 2012; 42(8): 741-751. doi:10.1007/s00595-012-0127-7
- 17Narkewicz MR, Green M, Dunn S, et al. Decreasing incidence of symptomatic Epstein–Barr virus disease and posttransplant lymphoproliferative disorder in pediatric liver transplant recipients: report of the studies of pediatric liver transplantation experience. Liver Transpl. 2013; 19(7): 730-740. doi:10.1002/lt.23659
- 18Das B, Morrow R, Huang R, Fixler D. Persistent Epstein–Barr viral load in Epstein–Barr viral naive pediatric heart transplant recipients: risk of late-onset post-transplant lymphoproliferative disease. World J Transplant. 2016; 6(4): 729-735. doi:10.5500/wjt.v6.i4.729
- 19Jeong HJ, Ahn YH, Park E, et al. Posttransplantation lymphoproliferative disorder after pediatric solid organ transplantation: experiences of 20 years in a single center. Korean J Pediatr. 2017; 60(3): 86-93. doi:10.3345/kjp.2017.60.3.86
- 20Karakoyun M, Önen Ş, Baran M, et al. Post-transplant malignancies in pediatric liver transplant recipients: experience of two centers in Turkey. Turk J Gastroenterol. 2018; 29(1): 89-93. doi:10.5152/tjg.2017.17089
- 21Thergaonkar RW, Bhardwaj S, Sinha A, et al. Posttransplant lymphoproliferative disorder: experience from a pediatric nephrology unit in North India. Indian J Nephrol. 2018; 28(5): 374-377. doi:10.4103/ijn.IJN_143_17
- 22Savoldo B, Quiros-Tejeirab CM, et al. Cellular immunity to Epstein–Barr virus in liver transplant recipients treated with rituximab for post-transplant lymphoproliferative disease. Am J Transplant. 2005; 5: 566-572.
- 23Wilsdorf N, Eiz-Vesper B, Henke-Gendo C, et al. EBV-specific T-cell immunity in pediatric solid organ graft recipients with posttransplantation lymphoproliferative disease. Transplantation. 2013; 95(1): 247-255. doi:10.1097/TP.0b013e318279968d
- 24Nouwen J, Smets F, Rombaux P, Hamoir M, Sokal EM. Acute tonsillitis as the first manifestation of post-transplant lymphoproliferative disorder. Ann Otol Rhinol Laryngol. 2002; 111(2): 165-168.
- 25Nelson BP, Wolniak KL, Evens A, Chenn A, Maddalozzo J, Proytcheva M. Early posttransplant lymphoproliferative disease: clinicopathologic features and correlation with mTOR signaling pathway activation. Am J Clin Pathol. 2012; 138(4): 568-578.
- 26Hurwitz M, Desai DM, Cox KL, Berquist WE, Esquivel CO, Millan MT. Complete immunosuppressive withdrawal as a uniform approach to post-transplant lymphoproliferative disease in pediatric liver transplantation. Pediatr Transplant. 2004; 8(3): 267-272.
- 27Smets F, Vajro P, Cornu G, Reding R, Otte JB, Sokal E. Indications and results of chemotherapy in children with posttransplant lymphoproliferative disease after liver transplantation. Transplantation. 2000; 69(5): 982-984.
- 28Comoli P, Maccario R, Locatelli F, et al. Treatment of EBV-related post-renal transplant lymphoproliferative disease with a tailored regimen including EBV-specific T-cells. Am J Transplant. 2005; 5: 1415-1422.
- 29Dror Y, Greenberg M, Taylor G, et al. Lymphoproliferative disorders after organ transplantation in children. Transplantation. 1999; 67: 990-998.
- 30Gholipour-Shoiili A, Gholipour-Shoiili H, Taheri S. An approach to finding indications and contraindications for nephrectomy in post-transplant renal graft lymphomas: PTLD. Int survey. Hematol Oncol Stem Cell Ther. 2011; 4(4): 167-172. doi:10.5144/1658-3876.2011.167
- 31Rossignol J, Terriou L, Robu D, et al. Radioimmunotherapy (90Y-ibritumomab tiuxetan) for posttransplant lymphoproliferative disorders after prior exposure to rituximab. Am J Transplant. 2015; 15: 1976-1981.
- 32Green M. Management of Epstein–Barr virus-induced posttransplant lymphoproliferative disease in recipients of solid organ transplantation. Am J Transplant. 2001; 1: 103-108.
- 33Meng Q, Hagemeier SR, Fingeroth JD, et al. The Epstein–Barr virus (EBV)-encoded protein kinase, EBV-PK, but not the thymidine kinase (EBV-TK), is required for ganciclovir and acyclovir inhibition of lytic viral production. J Virol. 2010; 84: 4534-4542.
- 34Cheng YC, Huang ES, Lin JC, et al. Unique spectrum of activity of 9-[(1,3-dihydroxy-2-propoxy)methyl]-guanine against herpesviruses in vitro and its mode of action against herpes simplex virus type 1. Proc Natl Acad Sci USA. 1983; 80: 2767-2770.
- 35Matthews T, Boehme R. Antiviral activity and mechanism of action of ganciclovir. Rev Infect Dis. 1988; 10(Suppl 3): S490-S494.
- 36Schnute ME, Anderson DJ, Brideau RJ, et al. 2-Aryl-2-hydroxyethylamine substituted 4-oxo-4,7-dihydrothieno[2,3-b]pyridines as broad-spectrum inhibitors of human herpesvirus polymerases. Bioorg Med Chem Lett. 2007; 17: 3349-3353.
- 37Zacny VL, Gershburg E, Davis MG, Biron KK, Pagano JS. Inhibition of Epstein–Barr virus replication by a benzimidazole L-riboside: novel antiviral mechanism of 5,6-dichloro-2-(isopropylamino)-1-beta-L-ribofuranosyl-1H-benzimidazole. J Virol. 1999; 73: 7271-7277.
- 38Montone KT, Hodinka RL, Salhany KE, Lavi E, Rostami A, Tomaszewski JE. Identification of Epstein–Barr virus lytic activity in post-transplantation lymphoproliferative disease. Mod Pathol. 1996; 9(6): 621-630.
- 39Fink SE, Gandhi MK, Nourse JP, et al. A comprehensive analysis of the cellular and EBV-specific microRNAome in primary CNS PTLD identifies different patterns among EBV-associated tumors. Am J Transplant. 2014; 14(11): 2577-2587. doi:10.1111/ajt.12858
- 40Morscio J, Finalet Ferreiro J, Vander Borght S, et al. Identification of distinct subgroups of EBV-positive post-transplant diffuse large B-cell lymphoma. Mod Pathol. 2017; 30(3): 370-381. doi:10.1038/modpathol.2016.199
- 41Perrine S, Hermine O, Small T, et al. A phase 1/2 trial of arginine butyrate and ganciclovir in patients with Epstein–Barr virus-associated lymphoid malignancies. Blood. 2007; 109: 2571-2578.
- 42Reid E. Bortezomib-induced Epstein–Barr virus and Kaposi sarcoma herpesvirus lytic gene expression: oncolytic strategies. Curr Opin Oncol. 2011; 23: 482-487.
- 43Green M, Michaels MG, Katz BZ, et al. CMV-IVIG for prevention of Epstein–Barr virus disease and posttransplant lymphoproliferative disease in pediatric liver transplant recipients. Am J Transplant. 2006; 6(8): 1906-1912. doi:10.1111/j.1600-6143.2006.01394.x
- 44Humar A, Hébert D, Davies D, et al. A multi-center randomized trial of ganciclovir versus ganciclovir plus immune globulin for prophylaxis against EBV related post-transplant lymphoproliferative disorder (PTLD) in high-risk solid organ transplant recipients. Transplantation. 2006; 81: 856-861.
- 45Benkerrou M, Jais JP, Leblond V, et al. Anti-B-cell monoclonal antibody treatment of sever posttransplant B-lymphoproliferative disorder: prognostic factors and long-term outcome. Blood. 1998; 92: 3137-3147.
- 46Choquet S, Leblond V, Herbrecht R, et al. Efficacy and safety of rituximab in B-cell posttransplant lymphoproliferative disorders: results of a prospective multicenter phase 2 study. Blood. 2006; 107: 3053-3057.
- 47Trappe R, Diericks D, Zimmermann H, et al. Response to rituximab induction is a predictive marker in B-cell post-transplant lymphoproliferative disorder and allows successful stratification into rituximab or R-CHOP consolidation in an international, prospective, multi-center phase II trial. J Clin Oncol. 2016; 35: 536-543.
- 48Gonzalez-Barca E, Domingo-Domenech E, Capote FJ, et al. Prospective phase II trial of extended treatment with rituximab in patients with B-cell post-transplant lymphoproliferative disease. Haematologica. 2007; 92: 1489-1494.
- 49Webber S, Harmon W, Faro A, et al. Anit-CD20 monoclonal antibody (rituximab) for refractory PTLD after pediatric solid organ transplantation: multicenter experience from a registry and prospective clinical trial. Blood. 2004; 104: 746.
- 50Maecker-Kolhoff B, Zimmermann M, Schlegelberger B, et al. Response-adapted sequential immune-chemotherapy of post-transplant lymphoproliferative disorders in pediatric solid organ transplant recipients: results from the prospective Ped-PTLD 2005 trial. Blood. 2014; 124: 4468.
- 51Webber S, Harmon W, Blume E, et al. Anti-CD20 monoclonal antibody (rituximab) for refractory pediatric post-transplant lymphoproliferative disorders: final results of a small phase II multicenter clinical trial. Am J Transplant. 2008; 8(Suppl 2): 308-309. doi:10.1111/j.1600-6143.2008.02251.x
10.1111/j.1600-6143.2008.02251.x Google Scholar
- 52Shah N, Eyre TA, Tucker D, et al. Front-line management of post-transplantation lymphoproliferative disorder in adult solid organ recipient patients—a British Society for Haematology guideline. Br J Haematol. 2021; 193: 727-740.
- 53Allen U, Preiksaitis J. Epstein–Barr virus and post-transplant lymphoproliferative disorder. Am J Transplant. 2013; 13: 107-113.
- 54Parker A, Bowles K, Bradley A, et al. Management of post-transplant lymphoproliferative disorder in adult solid organ transplant recipients – BCSH and BTS guidelines. Br J Haematol. 2010; 149: 693-705.
- 55Campo E, Jaffe ES, Cook JR, et al. The international consensus classification of mature lymphoid neoplasms: a report from the clinical advisory committee. Blood. 2022; 140: 1229-1253.
- 56Alaggio R, Amador C, Anagnostopoulos I, et al. The 5th edition of the World Health Organization classification of haematolymphoid tumours: lymphoid neoplasms. Leukemia. 2022; 36(7): 1720-1748.
- 57Trappe R, Oertel S, Leblond V, et al. Sequential treatment with rituximab followed by CHOP chemotherapy in adult B-cell post-transplant lymphoproliferative disorder (PTLD): the prospective international multicentre phase 2 PTLD-1 trial. Lancet Oncol. 2012; 13: 196-206.
- 58Maecker B, Jack T, Zimmermann M, et al. CNS or bone marrow involvement as risk factors for poor survival in post-transplantation lymphoproliferative disorders in children after solid organ transplantation. J Clin Oncol. 2007; 25(31): 4902-4908.
- 59Gross TG, Bucuvalas JC, Park JR, et al. Low-dose chemotherapy for Epstein–Barr virus-positive post-transplantation lymphoproliferative disease in children after solid organ transplantation. J Clin Oncol. 2005; 23: 6481-6488.
- 60Gross TG, Orjuela MA, Perkins SL, et al. Low-dose chemotherapy and rituximab for post-transplant lymphoproliferative disease (PTLD): a Children's Oncology Group Report. Am J Transplant. 2012; 12: 3069-3075.
- 61Maecker-Kolhoff B, Beier R, Zimmermann M, et al. Response-adapted sequential Immuno-chemotherapy of post-transplant lymphoproliferative disorders in pediatric solid organ transplant recipients: results from the prospective Ped-PTLD 2005 trial. Blood. 2014; 124(21): 4468.
- 62Zimmermann H, Reinke P, Neuhaus R, et al. Burkitt post-transplantation lymphoma in adult solid organ transplant recipients: sequential immunochemotherapy with rituximab (R) followed by cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) or R-CHOP is safe and effective in an analysis of 8 patients. Cancer. 2012; 118(19): 4715-4724. doi:10.1002/cncr.27482
- 63Picarsic J, Jaffe R, Mazariegos G, et al. Post-transplant Burkitt lymphoma is a more aggressive and distinct form of post-transplant lymphoproliferative disorder. Cancer. 2011; 117(19): 4540-4550. doi:10.1002/cncr.26001
- 64Afify Z, Orjuela-Grimm M, Smith CM, et al. Burkitt lymphoma after solid-organ transplant: treatment and outcomes in the paediatric PTLD collaborative. Br J Haematol. 2023; 200(3): 297-305.
- 65Kampers J, Orjuela-Grimm M, Schober T, et al. Classical Hodgkin lymphoma-type PTLD after solid organ transplantation in children: a report on 17 patients treated according to subsequent GPOH-HD treatment schedules. Leuk Lymphoma. 2017; 58(3): 633-638. doi:10.1080/10428194.2016.1205742
- 66Rosenberg AS, Klein AK, Ruthazer R, Evens AM. Hodgkin lymphoma post-transplant lymphoproliferative disorder: a comparative analysis of clinical characteristics, prognosis, and survival. Am J Hematol. 2016; 91(6): 560-565. doi:10.1002/ajh.24346
- 67Tiede C, Maecker-Kolhoff B, Klein C, Kreipe H, Hussein K. Risk factors and prognosis in T-cell posttransplantation lymphoproliferative diseases: reevaluation of 163 cases. Transplantation. 2013; 95(3): 479-488. doi:10.1097/TP.0b013e3182762e07
- 68Herreman A, Dierickx D, Morscio J, et al. Clinicopathological characteristics of posttransplant lymphoproliferative disorders of T-cell origin: single-center series of nine cases and meta-analysis of 147 reported cases. Leuk Lymphoma. 2013; 54(10): 2190-2199. doi:10.3109/10428194.2013.775436
- 69Choi M, Fink S, Prasad V, Anagnostopoulos I, Reinke P, Schmitt CA. T cell PTLD successfully treated with single-agent brentuximab vedotin first-line therapy. Transplantation. 2016; 100(3): e8-e10. doi:10.1097/TP.0000000000001099
- 70Plant AS, Venick RS, Farmer DG, Upadhyay S, Said J, Kempert P. Plasmacytoma-like post-transplant lymphoproliferative disorder seen in pediatric combined liver and intestinal transplant recipients. Pediatr Blood Cancer. 2013; 60(11): E137-E139. doi:10.1002/pbc.24632
- 71Perry AM, Aoun P, Coulter DW, Sanger WG, Grant WJ, Coccia PF. Early onset, EBV− PTLD in pediatric liver-small bowel transplantation recipients: a spectrum of plasma cell neoplasms with favorable prognosis. Blood. 2013; 121(8): 1377-1383.
- 72Chiou F, Beath S, Wilkie G, Vickers M, Morland B, Gupte G. Cytotoxic T-lymphocyte therapy for post-transplant lymphoproliferative disorder after solid organ transplantation in children. Pediatr Transplant. 2015; 22:e13133.
- 73Haque T, Wilkie GM, Taylor C, et al. Treatment of Epstein–Barr-virus-positive post-transplantation lymphoproliferative disease with partly HLA-matched allogeneic cytotoxic T-cells. Lancet. 2002; 360(9331): 436-442.
- 74Haque T, Wilkie G, Jones M, et al. Allogeneic cytotoxic T-cell therapy for EBV positive post-transplantation lymphoproliferative disease: results of a phase 2 multicenter clinical trial. Blood. 2007; 110: 1123-1131.
- 75Prockop S, Doubrovina E, Stephanie Suser S, et al. Off-the-shelf EBV-specific T-cell immunotherapy for rituximab-refractory EBV-associated lymphoma following transplantation. J Clin Invest. 2020; 130(2): 733-747.
- 76Wistinghausen B, Toner K, Barkauskas DA, et al. ANHL1522: durable immunity to EBV post rituximab and third party LMP-specific T-cells: a children's oncology group study. Blood Adv. 2024; 8: 1116-1127. doi:10.1182/bloodadvances.2023010832
- 77O'Brien S, Bernert RA, Logan JL, Lien YH. Remission of posttransplant lymphoproliferative disorder after interferon alfa therapy. J Am Soc Nephrol. 1997; 8(9): 1483-1489. doi:10.1681/ASN.V891483
- 78Durandy A. Anti-B cell and anti-cytokine therapy for the treatment of post-transplant lymphoproliferative disorder: past, present, and future. Transpl Infect Dis. 2001; 3(2): 104-107.
- 79Hartmann C, Schuchmann M, Zimmermann T. Posttransplant lymphoproliferative disease in liver transplant patients. Curr Infect Dis Rep. 2011; 13(1): 53-59. doi:10.1007/s11908-010-0145-9
- 80Zimmermann H, Trappe RU. Therapeutic options in post-transplant lymphoproliferative disorders. Ther Adv Hematol. 2011; 2(6): 393-407. doi:10.1177/2040620711412417
- 81Cantarovich M, Barkun JS, Forbes RD, Kosiuk JP, Tchervenkov JI. Successful treatment of post-transplant lymphoproliferative disorder with interferon-alpha and intravenous immunoglobulin. Clin Transpl. 1998; 12(2): 109-115.
- 82Davis CL. Interferon and cytotoxic chemotherapy for the treatment of post-transplant lymphoproliferative disorder. Transpl Infect Dis. 2001; 3(2): 108-118. doi:10.1034/j.1399-3062.2001.003002108.x
- 83Schaar CG, van der Pijl JW, van Hoek B, et al. Successful outcome with a “quintuple approach” of posttransplant lymphoproliferative disorder. Transplantation. 2001; 71(1): 47-52. doi:10.1097/00007890-200101150-00008
- 84Swinnen LJ, LeBlanc M, Grogan TM, et al. Prospective study of sequential reduction in immunosuppression, interferon alpha-2B, and chemotherapy for posttransplantation lymphoproliferative disorder. Transplantation. 2008; 86(2): 215-222. doi:10.1097/TP.0b013e3181761659
- 85Taguchi Y, Purtilo DT, Okano M. The effect of intravenous immunoglobulin and interferon-alpha on Epstein–Barr virus-induced lymphoproliferative disorder in a liver transplant recipient. Transplantation. 1994; 57(12): 1813-1815.
- 86Haddad E, Paczesny S, Leblond V, et al. Treatment of B-lymphoproliferative disorder with a monoclonal anti-interleukin-6 antibody in 12 patients: a multicenter phase 1–2 clinical trial. Blood. 2001; 97(6): 1590-1597. doi:10.1182/blood.v97.6.1590
- 87Kinch A, Sundström C, Baecklund E, Backlin C, Molin D, Enblad G. Expression of PD-1, PD-L1, and PD-L2 in posttransplant lymphoproliferative disorder after solid organ transplantation. Leuk Lymphoma. 2019; 60(2): 376-384. doi:10.1080/10428194.2018.1480767
- 88Kim SJ, Hyeon J, Cho I, Ko YH, Kim WS. Comparison of efficacy of pembrolizumab between Epstein–Barr virus-positive and -negative relapsed or refractory non-Hodgkin lymphomas. Cancer Res Treat. 2019; 51(2): 611-622. doi:10.4143/crt.2018.191
- 89Kassa C, Reményi P, Sinkó J, Kállay K, Kertész G, Kriván G. Successful nivolumab therapy in an allogeneic stem cell transplant child with post-transplant lymphoproliferative disorder. Pediatr Transplant. 2018; 22(8):e13302. doi:10.1111/petr.13302
- 90Penn I, Porat G. Central nervous system lymphomas in organ allograft recipients. Transplantation. 1995; 59(2): 240-244.
- 91Buell JF, Gross TG, Hanaway MJ, et al. Posttransplant lymphoproliferative disorder: significance of central nervous system involvement. Transplant Proc. 2005; 37(2): 954-955.
- 92Cavaliere R, Petroni G, Lopes MB, Schiff D, International Primary Central Nervous System Lymphoma Collaborative Group. Primary central nervous system post-transplantation lymphoproliferative disorder: an international primary central nervous system lymphoma collaborative group report. Cancer. 2010; 116(4): 863-870. doi:10.1002/cncr.24834
- 93Evens AM, Choquet S, Kroll-Desrosiers AR, et al. Primary CNS posttransplant lymphoproliferative disease (PTLD): an international report of 84 cases in the modern era. Am J Transplant. 2013; 13(6): 1512-1522. doi:10.1111/ajt.12211
- 94Lake W, Chang JE, Kennedy T, Morgan A, Salamat S, Başkaya MK. A case series of primary central nervous system posttransplantation lymphoproliferative disorder: imaging and clinical characteristics. Neurosurgery. 2013; 72(6): 960-970. doi:10.1227/NEU.0b013e31828cf619
- 95Valavoor SH, Ashraf Z, Narwal R, Ratnam S. Conservative management of post-transplant central nervous system lymphoma. Int Urol Nephrol. 2013; 45(4): 1219-1222. doi:10.1007/s11255-012-0146-8
- 96Dugan JP, Haverkos BM, Villagomez L, et al. Complete and durable responses in primary central nervous system posttransplant lymphoproliferative disorder with zidovudine, ganciclovir, rituximab, and dexamethasone. Clin Cancer Res. 2018; 24(14): 3273-3281. doi:10.1158/1078-0432.CCR-17-2685
- 97Patrick A, Wee A, Hedderman A, Wilson D, Weiss J, Govani M. High-dose intravenous rituximab for multifocal, monomorphic primary central nervous system posttransplant lymphoproliferative disorder. J Neuro-Oncol. 2011; 103(3): 739-743. doi:10.1007/s11060-010-0425-0
- 98Wu M, Sun J, Zhang Y, et al. Intrathecal rituximab for EBV-associated post-transplant lymphoproliferative disorder with central nervous system involvement unresponsive to intravenous rituximab-based treatments: a prospective study. Bone Marrow Transplant. 2016; 51(3): 456-458. doi:10.1038/bmt.2015.281
- 99Czyzewski K, Styczynski J, Krenska A, et al. Intrathecal therapy with rituximab in central nervous system involvement of post-transplant lymphoproliferative disorder. Leuk Lymphoma. 2013; 54(3): 503-506. doi:10.3109/10428194.2012.718342
- 100Twombley K, Pokala H, Ardura MI, et al. Intraventricular rituximab and systemic chemotherapy for treatment of central nervous system post-transplant lymphoproliferative disorder after kidney transplantation. Pediatr Transplant. 2012; 16(6): E201-E209. doi:10.1111/j.1399-3046.2012.01699.x
- 101Twist CJ, Castillo RO. Treatment of recurrent posttransplant lymphoproliferative disorder of the central nervous system with high-dose methotrexate. Case Rep Transplant. 2013; 2013:765230. doi:10.1155/2013/765230
- 102Taj MM, Messahel B, Mycroft J, et al. Efficacy and tolerability of high-dose methotrexate in central nervous system positive or relapsed lymphoproliferative disease following liver transplant in children. Br J Haematol. 2008; 140(2): 191-196. doi:10.1111/j.1365-2141.2007.06896.x
- 103Mahapatra S, Chin CC, Iagaru A, Heerema-McKenney A, Twist CJ. Successful treatment of systemic and central nervous system post-transplant lymphoproliferative disorder without the use of high-dose methotrexate or radiation. Pediatr Blood Cancer. 2014; 61(11): 2107-2109. doi:10.1002/pbc.25129
- 104Schultze-Florey RE, Tischer S, Kuhlmann L, et al. Dissecting Epstein–Barr virus-specific T-cell responses after allogeneic EBV-specific T-cell transfer for central nervous system posttransplant lymphoproliferative disease. Front Immunol. 2018; 9: 1475. doi:10.3389/fimmu.2018.01475
- 105Benitez CM, Rahimy E, Panjwani N, et al. Stereotactic radiotherapy for recurrent post-transplant primary central nervous. System Lymphoma Cureus. 2021; 13(7):e16537. doi:10.7759/cureus.16537
- 106Majewski M, Korecka M, Kossev P, et al. The immunosuppressive macrolide RAD inhibits growth of human Epstein–Barr virus-transformed B lymphocytes in vitro and in vivo: a potential approach to prevention and treatment of posttransplant lymphoproliferative disorders. Proc Natl Acad Sci USA. 2000; 97(8): 4285-4290.
- 107Majewski M, Korecka M, Joergensen J, et al. Immunosuppressive TOR kinase inhibitor everolimus (RAD) suppresses growth of cells derived from posttransplant lymphoproliferative disorder at allograft-protecting doses. Transplantation. 2003; 75(10): 1710-1717.
- 108Furukawa S, Wei L, Krams SM, Esquivel CO, Martinez OM. PI3Kδ inhibition augments the efficacy of rapamycin in suppressing proliferation of Epstein–Barr virus (EBV)+ B cell lymphomas. Am J Transplant. 2013; 13(8): 2035-2043. doi:10.1111/ajt.12328
- 109Sang AX, McPherson MC, Ivison GT, et al. Dual blockade of the PI3K/Akt/mTOR pathway inhibits posttransplant Epstein–Barr virus B cell lymphomas and promotes allograft survival. Am J Transplant. 2019; 19(5): 1305-1314. doi:10.1111/ajt.15216
- 110Bak S, Tischer S, Dragon A, et al. Selective effects of mTOR inhibitor sirolimus on naïve and CMV-specific T cells extending its applicable range beyond immunosuppression. Front Immunol. 2018; 9: 2953. doi:10.3389/fimmu.2018.02953
- 111Wowro SJ, Schmitt KRL, Tong G, Berger F, Schubert S. Effects of mTOR and calcineurin inhibitors combined therapy in Epstein–Barr virus positive and negative Burkitt lymphoma cells. Int Immunopharmacol. 2016; 30: 9-17. doi:10.1016/j.intimp.2015.11.020
- 112Sampaio MS, Cho YW, Shah T, Bunnapradist S, Hutchinson IV. Association of immunosuppressive maintenance regimens with posttransplant lymphoproliferative disorder in kidney transplant recipients. Transplantation. 2012; 93(1): 73-81. doi:10.1097/TP.0b013e31823ae7db
- 113Kirk AD, Cherikh WS, Ring M, et al. Dissociation of depletional induction and posttransplant lymphoproliferative disease in kidney recipients treated with alemtuzumab. Am J Transplant. 2007; 7(11): 2619-2625.
- 114Kranz B, Wingen AM, Vester U, König J, Hoyer PF. Long-term side effects of treatment with mTOR inhibitors in children after renal transplantation. Pediatr Nephrol. 2013; 28(8): 1293-1298. doi:10.1007/s00467-013-2459-y
- 115Ashrafi F, Shahidi S, Ebrahimi Z, Mortazavi M. Outcome of rapamycin therapy for post-transplant-lymphoproliferative disorder after kidney transplantation: case series. Int J Hematol Oncol Stem Cell Res. 2015; 9(1): 26-32.
- 116Boratyńska M, Watorek E, Smolska D, Patrzałek D, Klinger M. Anticancer effect of sirolimus in renal allograft recipients with de novo malignancies. Transplant Proc. 2007; 39(9): 2736-2739.
- 117Pascual J. Post-transplant lymphoproliferative disorder—the potential of proliferation signal inhibitors. Nephrol Dial Transplant. 2007; 22(Suppl 1): i27-i35.
- 118Asante-Korang A, Carapellucci J, Krasnopero D, Doyle A, Brown B, Amankwah E. Conversion from calcineurin inhibitors to mTOR inhibitors as primary immunosuppressive drugs in pediatric heart transplantation. Clin Transpl. 2017; 31(10). doi:10.1111/ctr.13054
- 119Ganschow R, Ericzon BG, Dhawan A, et al. Everolimus and reduced calcineurin inhibitor therapy in pediatric liver transplant recipients: results from a multicenter, prospective study. Pediatr Transplant. 2017; 21(7). doi:10.1111/petr.13024
- 120Mazariegos GV, Sindhi R, Thomson AW, Marcos A. Clinical tolerance following liver transplantation: long term results and future prospects. Transpl Immunol. 2007; 17(2): 114-119. doi:10.1016/j.trim.2006.09.033
- 121Talisetti A, Hurwitz M, Sarwal M, et al. Analysis of clinical variables associated with tolerance in pediatric liver transplant recipients. Pediatr Transplant. 2010; 14(8): 976-979. doi:10.1111/j.1399-3046.2010.01360.x
- 122Kullberg-Lindh C, Saalman R, Olausson M, Herlenius G, Lindh M. Epstein–Barr virus DNA monitoring in serum and whole blood in pediatric liver transplant recipients who do or do not discontinue immunosuppressive therapy. Pediatr Transplant. 2017; 21(5). doi:10.1111/petr.12875
- 123Kinch A, Baecklund E, Backlin C, et al. A population-based study of 135 lymphomas after solid organ transplantation: the role of Epstein–Barr virus, hepatitis C and diffuse large B cell lymphoma subtype in clinical presentation and survival. Acta Oncol. 2014; 53(5): 669-679. doi:10.3109/0284186X.2013.844853
- 124Morton M, Coupes B, Ritchie J, et al. Post-transplant lymphoproliferative disorder in adult renal transplant recipients: survival and prognosis. Leuk Lymphoma. 2015; 57: 299-305.
- 125Mahale P, Shiels M, Lynch C, Engels E. Incidence and outcomes of primary central nervous system lymphoma in solid organ transplant recipients. Am J Transplant. 2018; 18: 453-461.
- 126Izadi M, Fazel M, Saadat SH, Taheri S. Bone marrow involvement by lymphoproliferative disorders after renal transplantation: PTLD. Int. Survey. J Cancer Res Ther. 2012; 8(1): 62-67.
- 127L'Huillier AG, Dipchand AI, Ng VL, et al. Posttransplant lymphoproliferative disorder in pediatric patients: survival rates according to primary sites of occurrence and a proposed clinical categorization. Am J Transplant. 2019; 19(10): 2764-2774. doi:10.1111/ajt.15358
- 128Caillard S, Porcher R, Provot F, et al. Post-transplantation lymphoproliferative disorder after kidney transplantation: report of a nationwide French registry and the development of a new prognostic score. J Clin Oncol. 2013; 31(10): 1302-1309.
- 129Johnson SR, Cherikh WS, Kauffman HM, Pavlakis M, Hanto DW. Retransplantation after post-transplant lymphoproliferative disorders: an OPTN/UNOS database analysis. Am J Transplant. 2006; 6(11): 2743.
- 130Karras A, Thervet E, Le Meur Y, Baudet-Bonneville V, Kessler M, Legendre C. Successful renal retransplantation after post-transplant lymphoproliferative disease. Am J Transplant. 2004; 4: 1904-1909.
- 131Hanto DW. Retransplantation after post-transplant lymphoproliferative diseases (PTLD): when is it safe? Am J Transplant. 2004; 4: 1733-1734.
- 132Caillard S, Cellot E, Dantal J, et al. A French cohort study of kidney retransplantation after post-transplant lymphoproliferative disorders. Clin J Am Soc Nephrol. 2017; 12(10): 1663-1670.
- 133Parker A, Bowles K, Bradley A, et al. Diagnosis of post-transplant lymphoproliferative disorder in solid organ transplant recipients-BCSH and BTS guidelines. Br J Haematol. 2010; 149: 675-692.
- 134Green M, Cacciarelli TV, Mazariegos GV, et al. Serial measurement of Epstein–Barr viral load in peripheral blood in pediatric liver transplant recipients during treatment for posttransplant lymphoproliferative disease. Transplantation. 1998; 66: 1641-1644.
- 135Yang J, Tao Q, Flinn IW, et al. Characterization of Epstein–Barr virus-infected B cells in patients with posttransplantation lymphoproliferative disease: disappearance after rituximab therapy does not predict clinical response. Blood. 2000; 96: 4055-4063.
- 136Oertel S, Trappe RU, Zeidler K, et al. Epstein–Barr viral load in whole blood of adults with posttransplant lymphoproliferative disorder after solid organ transplantation does not correlate with clinical course. Ann Hematol. 2006; 85: 478-484.
- 137Whelass SA, Gulley ML, Raab-Traub N, et al. Post-transplantation lymphoproliferative disease. Epstein–Barr virus DNA levels, HLA-A3 and survival. Am J Respir Crit Care Med. 2008; 178: 1060-1065.
- 138Van Esser JWJ, Niesters HGM, Thijsen SFT, et al. Molecular quantification of viral load in plasma allows for fast and accurate prediction of response to therapy of Epstein–Barr virus-associated lymphoproliferative disease after allogeneic stem cell transplantation. Br J Haematol. 2001; 113: 814-821.
- 139Kanakry J, Hegde A, Durand C, et al. The clinical significance of EBV DNA in the plasma and peripheral blood mononuclear cells of patients with or without EBV diseases. Blood. 2016; 127(16): 2007-2010.
- 140Barrington SF, Mikhaeel NG, Kostakoglu L, et al. Role of imaging in the staging and response assessment of lymphoma: consensus of the international conference on malignant lymphomas imaging working group. J Clin Oncol. 2014; 32(27): 3048-3058.
- 141Juweid ME, Wiseman GA, Vose JM, et al. Response assessment of aggressive non-Hodgkin's lymphoma by integrated international workshop criteria and fluorine-18-fluorodeoxyglucose positron emission tomography. J Clin Oncol. 2005; 23(21): 4652-4661.
- 142Dierickx D, Tousseyn T, Requilé A, et al. The accuracy of positron emission tomography in the detection of posttransplant lymphoproliferative disorder. Haematologica. 2013; 98(5): 771-775.
- 143Vali R, Punnett A, Bajno L, Moineddin R, Shammas A. The value of 18F-FDG PET in pediatric patients with post-transplant lymphoproliferative disorder at initial diagnosis. Pediatr Transplant. 2015; 19(8): 932-939. doi:10.1111/petr.12611
- 144Zimmermann H, Denecke T, Dreyling MH, et al. End-of-treatment positron emission tomography after uniform first-line therapy of B cell posttransplant lymphoproliferative disorder identifies patients at low risk of relapse in the prospective German PTLD registry. Transplantation. 2018; 102(5): 868-875.
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