Nephrol Dial Transplant (1989) 4: 818-823
© 1989 European Renal Association-European Dialysis and Transplant Association
research-article
Epstein-Barr Virus Associated Lymphoproliferative Diseases (B Cell Lymphoma) After Transplantation
1Transplantation Unit, Hôpital Edouard Herriot Lyon, France 2Laboratoire d'Anatomie Pathologique, Hôpital Edouard Herriot Lyon, France 3Centre de Transfusion Sanguine Lyon, France 4International Agency for Research on Cancer Lyon, France 5Service de Biochimie, Hôpital Edouard Herriot Lyon, France
Correspondence and offprint requests to: Correspondence and offprint requests to: J. L. Garnier, Pav P, Service du Pr. J. L. Touraine, Hôpital Edouard Herriot, Place d'Arsonval, 69437 Lyon Cedex 03, France
We report 12 cases of lymphomas which occurred among 1670 patients with kidney or combined renal and pancreatic transplantation. Group 1 comprised nine patients presenting with the diffuse form of the disease where immunoblasts or mature plasma cells massively infiltrated all organs. The first symptom was a viral syndrome, associated with a restriction of heterogeneity of immunoglobulins; oligoclonal to monoclonal peaks of immunoglobulins appeared about 50 days after transplantation. All patients received antilymphocyte globulins (ALG), and seven were treated with cyclosporin. EBV infection could be demonstrated in almost all patients; three EBV lymphoblastoïd cell lines were established, their HLA phenotype being the same as the recipient of the graft. All patients finally died with renal and hepatic failure. Group 2 comprises three patients who presented solid B cell tumours of tonsils, lungs, and spleen at onset, extending to liver, kidney graft, lymph nodes, and brain. All received cyclosporin; two patients were treated with ALG, and one with OKT3. Immunoglobulins were polyclonal, oligoclonal, or decreased. Cell surface immunoglobulins were monoclonal on two tumours. EBV-DNA was positive within two tumours. Two patients presented EBV and CMV primary infection. CD4+T lymphocytes subsets were diminished at onset, and increased after cessation of immunosuppressive therapy. One patient died because of brain involvement; the two others are alive, one with perfect graft function. Therapy consisted of stopping immunosuppressive treatment, Acyclovir, and in two patients of group 2, monoclonal antibodies to pan-B and EBV receptor antigens.
Keywords: EBV lymphoma; Transplant recipient; Immunosuppressive therapy; Cyclosporin; ALG; Restriction of heterogeneity of immunoglobulins; Therapeutic monoclonal antibodies
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  W. H. Lim, S. Kireta, G. R. Russ, and P. T. H. Coates Human plasmacytoid dendritic cells regulate immune responses to Epstein-Barr virus (EBV) infection and delay EBV-related mortality in humanized NOD-SCID mice Blood, February 1, 2007; 109(3): 1043 - 1050. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. Vazirabadi, T. R. Geiger, W. F. Coffin, III, and J. M. Martin Epstein-Barr virus latent membrane protein-1 (LMP-1) and lytic LMP-1 localization in plasma membrane-derived extracellular vesicles and intracellular virions J. Gen. Virol., August 1, 2003; 84(8): 1997 - 2008. [Abstract] [Full Text] [PDF]
|
|