Post-transplant lymphoproliferative disorders: From epidemiology to pathogenesis-driven treatment

Petrara, Maria Raffaella, Giunco, Silvia, Serraino, Diego, Dolcetti, Riccardo and De Rossi, Anita (2015) Post-transplant lymphoproliferative disorders: From epidemiology to pathogenesis-driven treatment. Cancer Letters, 369 1: 37-44. doi:10.1016/j.canlet.2015.08.007


Author Petrara, Maria Raffaella
Giunco, Silvia
Serraino, Diego
Dolcetti, Riccardo
De Rossi, Anita
Title Post-transplant lymphoproliferative disorders: From epidemiology to pathogenesis-driven treatment
Journal name Cancer Letters   Check publisher's open access policy
ISSN 0304-3835
1872-7980
Publication date 2015-12-01
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1016/j.canlet.2015.08.007
Open Access Status Not Open Access
Volume 369
Issue 1
Start page 37
End page 44
Total pages 8
Place of publication E Park, Shannon, Clare Ireland
Publisher Elsevier Ireland
Collection year 2016
Language eng
Abstract Post-transplant lymphoproliferative disorders (PTLDs) represent the most severe complication of both solid organ and hematopoietic stem cell transplantation. The Epstein–Barr Virus (EBV) is the main driver of PTLD, particularly those occurring early after transplantation. EBV-driven malignancies are associated with selective expression of latent viral proteins, but uncontrolled lytic replication may favor early phases of cell transformation. Besides immunodepression, persistent immune activation and chronic inflammation play an important role in both virus reactivation and expansion of EBV-infected B cells. EBV-induced immortalization requires the expression of telomerase. TERT, the rate-limiting component of the telomerase complex, is central in the switch from the lytic to the latent viral program, and TERT inhibition induces the EBV lytic cycle and cell death. Immunotherapy and combination of EBV lytic cycle inducers with antiviral drugs are promising strategies to improve the treatment of PTLD patients. This review is aimed at providing an update on the intriguing association between EBV and PTLD, mainly focusing on cases arising after kidney and liver transplantation, which account for the vast majority of transplants.
Keyword Ptld
Ebv
Inflammation/immune activation
Latent/lytic viral cycle
Telomerase
Treatment
Epstein-Barr-Virus
Stem-Cell Transplantation
Polymerase-Chain-Reaction
Single-Center-Experience
Viral Gene-Expression
Liver-Transplantation
Kidney-Transplantation
Peripheral-Blood
B-Lymphocytes
Immune Activation
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: Non HERDC
UQ Diamantina Institute - Open Access Collection
 
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