Post transplant lymphoproliferative disorder

Jump to navigation Jump to search

WikiDoc Resources for Post transplant lymphoproliferative disorder

Articles

Most recent articles on Post transplant lymphoproliferative disorder

Most cited articles on Post transplant lymphoproliferative disorder

Review articles on Post transplant lymphoproliferative disorder

Articles on Post transplant lymphoproliferative disorder in N Eng J Med, Lancet, BMJ

Media

Powerpoint slides on Post transplant lymphoproliferative disorder

Images of Post transplant lymphoproliferative disorder

Photos of Post transplant lymphoproliferative disorder

Podcasts & MP3s on Post transplant lymphoproliferative disorder

Videos on Post transplant lymphoproliferative disorder

Evidence Based Medicine

Cochrane Collaboration on Post transplant lymphoproliferative disorder

Bandolier on Post transplant lymphoproliferative disorder

TRIP on Post transplant lymphoproliferative disorder

Clinical Trials

Ongoing Trials on Post transplant lymphoproliferative disorder at Clinical Trials.gov

Trial results on Post transplant lymphoproliferative disorder

Clinical Trials on Post transplant lymphoproliferative disorder at Google

Guidelines / Policies / Govt

US National Guidelines Clearinghouse on Post transplant lymphoproliferative disorder

NICE Guidance on Post transplant lymphoproliferative disorder

NHS PRODIGY Guidance

FDA on Post transplant lymphoproliferative disorder

CDC on Post transplant lymphoproliferative disorder

Books

Books on Post transplant lymphoproliferative disorder

News

Post transplant lymphoproliferative disorder in the news

Be alerted to news on Post transplant lymphoproliferative disorder

News trends on Post transplant lymphoproliferative disorder

Commentary

Blogs on Post transplant lymphoproliferative disorder

Definitions

Definitions of Post transplant lymphoproliferative disorder

Patient Resources / Community

Patient resources on Post transplant lymphoproliferative disorder

Discussion groups on Post transplant lymphoproliferative disorder

Patient Handouts on Post transplant lymphoproliferative disorder

Directions to Hospitals Treating Post transplant lymphoproliferative disorder

Risk calculators and risk factors for Post transplant lymphoproliferative disorder

Healthcare Provider Resources

Symptoms of Post transplant lymphoproliferative disorder

Causes & Risk Factors for Post transplant lymphoproliferative disorder

Diagnostic studies for Post transplant lymphoproliferative disorder

Treatment of Post transplant lymphoproliferative disorder

Continuing Medical Education (CME)

CME Programs on Post transplant lymphoproliferative disorder

International

Post transplant lymphoproliferative disorder en Espanol

Post transplant lymphoproliferative disorder en Francais

Business

Post transplant lymphoproliferative disorder in the Marketplace

Patents on Post transplant lymphoproliferative disorder

Experimental / Informatics

List of terms related to Post transplant lymphoproliferative disorder

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Vamsikrishna Gunnam M.B.B.S [2] Maria Fernanda Villarreal, M.D. [3]

Synonyms and keywords: PTLD;

Overview

Post-transplant lymphoproliferative disorder (also known as PTLD) is defined as a lymphoid (immune cells) and/or plasmacytic proliferations (rapid increase) due to therapeutic immunosuppression after organ transplantation especially in the patients who are undergoing solid organ or allogeneic (donor) hematopoietic stem cell transplantation. Patients with post-transplant lymphoproliferative disorder may develop serious complications of transplantation with infectious mononucleosis-like lesions due to Epstein-Barr virus (EBV) or polyclonal polymorphic B-cell hyperplasia. In some cases, B-cells may undergo mutations which will render them malignant, giving rise to a lymphoma. The malignant cell clone can become the dominant proliferating cell type, leading to a group of B cell lymphomas occurring in immunosuppressed patients following organ transplant. Post transplant lymphoproliferative disorder arises from germinal center or post-germinal center B cells (B-PTLD), which are normally involved the production of antibodies and durable memory B cells. Post transplant lymphoproliferative disorder was first discovered by Denis Parsons Burkitt, an Irish physician, in 1965. According to World Health Organization (WHO) classification system, post transplant lymphoproliferative disorder may be classified into 4 subtypes: early hyperplastic lesions, polymorphic lesions, monomorphic lesions, and classic Hodgkin-type lymphomas. Post transplant lymphoproliferative disorder is very rare, and the prevalence of post transplant lymphoproliferative disorder remains unknown. Post transplant lymphoproliferative disorder is more commonly observed among young patients. The medical treatment for post transplant lymphoproliferative disorder, includes: immunosuppression, antiviral therapy, interferon alpha therapy, CD20 antibody therapy, and chemotherapy.

Historical Perspective

  • Post transplant lymphoproliferative disorder was first discovered by Denis Parsons Burkitt, an Irish physician, in 1965.
  • Post transplant lymphoproliferative disorder was first introduced in 1984 by Starzl.[1]

Classification

Category Subtype
Early hyperplastic lesions
Polymorphic lesions
Monomorphic lesions B-cell lymphomas

T-cell lymphomas

Other types

Pathophysiology

  • It is understood that post transplant lymphoproliferative disorder is the result of B cell proliferation induced by Epstein-Barr virus (EBV) infection.[4][5][6]
  • 90 to 95 percent of patients with post transplant lymphoproliferative disorder shows positive serologic of infection especially with Epstein-Barr virus (EBV) infection.[7]
  • Membrane proteins associated with EBV plays a major role in contribute to B cell growth and survival.[8][9][10][11][12][13]
    • LMP-1-Latent membrane protein 1
    • LMP-2A-Latent membrane protein 2
    • EBNA-2(Epstein-Barr nuclear antigen 2) and
    • EBNA-LP(Epstein-Barr nuclear antigen 2 ladder protein)
  • The overexpression of bcl-2 has been associated with the development of post transplant lymphoproliferative disorder.
  • On gross pathology, characteristic findings of post transplant lymphoproliferative disorder, include:
    • Resemblance to large cell lymphomas
    • No remarkable findings

Causes

Differentiating Post Transplant Lymphoproliferative Disorder from Other Diseases

Epidemiology and Demographics

Incidence

  • The incidence of post transplant lymphoproliferative disorder is approximately 20 percent of all cancers especially with solid organ transplantation.[20][21][22][23][24][25]
  • The incidence of post transplant lymphoproliferative disorder in liver transplants is approximately 1 to 2 percent.
  • The incidence of post transplant lymphoproliferative disorder in renal transplant is approximately 1 to 3 percent.
  • The incidence of post transplant lymphoproliferative disorder in heart transplant is approximately 2 to 6 percent.
  • The incidence of post transplant lymphoproliferative disorder in lung transplant is approximately 2 to 9 percent.
  • The incidence of post transplant lymphoproliferative disorder in intestinal or multi organ transplants is approximately as high as 11 to 33 percent.

Prevalence

  • The prevalence of post transplant lymphoproliferative disorder remains unknown.

Age

  • Post transplant lymphoproliferative disorder is more commonly observed among young patients.[26]

Gender

  • Females are slightly more affected with post transplant lymphoproliferative disorder than men.[27]

Race

  • There is no racial predilection for post transplant lymphoproliferative disorder.[28]

Risk Factors

Natural History, Complications and Prognosis

Natural History

  • The majority of patients with post transplant lymphoproliferative disorder are symptomatic at the time of diagnosis.
  • Early clinical features include fatigue, fever, and weight-loss.

Complications

  • If left untreated, patients with post transplant lymphoproliferative disorder may progress to develop organ failure.
  • The most common complication of post transplant lymphoproliferative disorder is fatal infection.

Prognosis

  • Depending on the extent of the disease progression at the time of diagnosis, the prognosis may vary in post transplant lymphoproliferative disorder patients due to heterogeneity of the disease.[35][36]
  • Prognosis also depends on what type of PTLD the patient is presenting with.
  • Prognosis is generally poor, and the 5-year survival rate of patients with post transplant lymphoproliferative disorder is approximately 37- 61%.
  • In post transplant lymphoproliferative disorder patients estimated average survival rates range from 25%–60%.

Diagnosis

Symptoms

  • Symptoms in post transplant lymphoproliferative disorder patients are highly variable.[18]
  • Symptoms are depends on type of post transplant lymphoproliferative disorder patient present with, and the organs involved.
  • Symptoms of post transplant lymphoproliferative disorder may include the following:[37]

Physical Examination

Laboratory Findings

Laboratory findings consistent with the diagnosis of post transplant lymphoproliferative disorder include:

Imaging Findings

Treatment

Medical Therapy

  • Pharmacologic medical therapies for post transplant lymphoproliferative disorder highly varied based on the subtype and type of transplant.[56]
  • In post transplant lymphoproliferative disorder patients standardized therapeutic approach cannot be applied to all patients.
  • The medical treatment for post transplant lymphoproliferative disorder, includes: [57]

Immunosuppression

Surgery

  • Surgery is not recommended for patients with post transplant lymphoproliferative disorder.[18]

Prevention

  • There are no primary preventive measures available for post transplant lymphoproliferative disorder.

References

  1. Petrara, Maria Raffaella; Giunco, Silvia; Serraino, Diego; Dolcetti, Riccardo; 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. ISSN 0304-3835.
  2. LaCasce, A. S. (2006). "Post-Transplant Lymphoproliferative Disorders". The Oncologist. 11 (6): 674–680. doi:10.1634/theoncologist.11-6-674. ISSN 1083-7159.
  3. Petrara, Maria Raffaella; Giunco, Silvia; Serraino, Diego; Dolcetti, Riccardo; 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. ISSN 0304-3835.
  4. Kotton CN, Fishman JA (June 2005). "Viral infection in the renal transplant recipient". J. Am. Soc. Nephrol. 16 (6): 1758–74. doi:10.1681/ASN.2004121113. PMID 15829710.
  5. Patton DF, Wilkowski CW, Hanson CA, Shapiro R, Gajl-Peczalska KJ, Filipovich AH, McClain KL (June 1990). "Epstein-Barr virus--determined clonality in posttransplant lymphoproliferative disease". Transplantation. 49 (6): 1080–4. PMID 2163133.
  6. Taylor AL, Marcus R, Bradley JA (October 2005). "Post-transplant lymphoproliferative disorders (PTLD) after solid organ transplantation". Crit. Rev. Oncol. Hematol. 56 (1): 155–67. doi:10.1016/j.critrevonc.2005.03.015. PMID 15979320.
  7. Hanto DW (1995). "Classification of Epstein-Barr virus-associated posttransplant lymphoproliferative diseases: implications for understanding their pathogenesis and developing rational treatment strategies". Annu. Rev. Med. 46: 381–94. doi:10.1146/annurev.med.46.1.381. PMID 7598473.
  8. Mosialos G, Birkenbach M, Yalamanchili R, VanArsdale T, Ware C, Kieff E (February 1995). "The Epstein-Barr virus transforming protein LMP1 engages signaling proteins for the tumor necrosis factor receptor family". Cell. 80 (3): 389–99. PMID 7859281.
  9. Izumi KM, Kaye KM, Kieff ED (February 1997). "The Epstein-Barr virus LMP1 amino acid sequence that engages tumor necrosis factor receptor associated factors is critical for primary B lymphocyte growth transformation". Proc. Natl. Acad. Sci. U.S.A. 94 (4): 1447–52. PMC 19811. PMID 9037073.
  10. Liebowitz D (May 1998). "Epstein-Barr virus and a cellular signaling pathway in lymphomas from immunosuppressed patients". N. Engl. J. Med. 338 (20): 1413–21. doi:10.1056/NEJM199805143382003. PMID 9580648.
  11. Thorley-Lawson DA (October 2001). "Epstein-Barr virus: exploiting the immune system". Nat. Rev. Immunol. 1 (1): 75–82. doi:10.1038/35095584. PMID 11905817.
  12. Kaiser C, Laux G, Eick D, Jochner N, Bornkamm GW, Kempkes B (May 1999). "The proto-oncogene c-myc is a direct target gene of Epstein-Barr virus nuclear antigen 2". J. Virol. 73 (5): 4481–4. PMC 104340. PMID 10196351.
  13. Randhawa PS, Jaffe R, Demetris AJ, Nalesnik M, Starzl TE, Chen YY, Weiss LM (December 1992). "Expression of Epstein-Barr virus-encoded small RNA (by the EBER-1 gene) in liver specimens from transplant recipients with post-transplantation lymphoproliferative disease". N. Engl. J. Med. 327 (24): 1710–4. doi:10.1056/NEJM199212103272403. PMC 2956494. PMID 1331789.
  14. Caillard S, Lelong C, Pessione F, Moulin B (November 2006). "Post-transplant lymphoproliferative disorders occurring after renal transplantation in adults: report of 230 cases from the French Registry". Am. J. Transplant. 6 (11): 2735–42. doi:10.1111/j.1600-6143.2006.01540.x. PMID 17049061.
  15. Smith JM, Rudser K, Gillen D, Kestenbaum B, Seliger S, Weiss N, McDonald RA, Davis CL, Stehmen-Breen C (January 2006). "Risk of lymphoma after renal transplantation varies with time: an analysis of the United States Renal Data System". Transplantation. 81 (2): 175–80. doi:10.1097/01.tp.0000188687.18972.a8. PMID 16436959.
  16. Caillard S, Dharnidharka V, Agodoa L, Bohen E, Abbott K (November 2005). "Posttransplant lymphoproliferative disorders after renal transplantation in the United States in era of modern immunosuppression". Transplantation. 80 (9): 1233–43. PMID 16314791.
  17. Bakker NA, van Imhoff GW, Verschuuren EA, van Son WJ, van der Heide JJ, Lems SP, Veeger NJ, Kluin PM, Kluin-Nelemans HC, Hepkema BG (September 2005). "HLA antigens and post renal transplant lymphoproliferative disease: HLA-B matching is critical". Transplantation. 80 (5): 595–9. PMID 16177631.
  18. 18.0 18.1 18.2 18.3 Taylor AL, Marcus R, Bradley JA (2005). "Post-transplant lymphoproliferative disorders (PTLD) after solid organ transplantation". Crit. Rev. Oncol. Hematol. 56 (1): 155–67. doi:10.1016/j.critrevonc.2005.03.015. PMID 15979320.
  19. Rohr JC, Wagner HJ, Lauten M, Wacker HH, Jüttner E, Hanke C, Pohl M, Niemeyer CM (June 2008). "Differentiation of EBV-induced post-transplant Hodgkin lymphoma from Hodgkin-like post-transplant lymphoproliferative disease". Pediatr Transplant. 12 (4): 426–31. doi:10.1111/j.1399-3046.2007.00816.x. PMID 18466428.
  20. Walker RC, Paya CV, Marshall WF, Strickler JG, Wiesner RH, Velosa JA, Habermann TM, Daly RC, McGregor CG (1995). "Pretransplantation seronegative Epstein-Barr virus status is the primary risk factor for posttransplantation lymphoproliferative disorder in adult heart, lung, and other solid organ transplantations". J. Heart Lung Transplant. 14 (2): 214–21. PMID 7779838.
  21. Reams BD, McAdams HP, Howell DN, Steele MP, Davis RD, Palmer SM (October 2003). "Posttransplant lymphoproliferative disorder: incidence, presentation, and response to treatment in lung transplant recipients". Chest. 124 (4): 1242–9. PMID 14555552.
  22. Adami J, Gäbel H, Lindelöf B, Ekström K, Rydh B, Glimelius B, Ekbom A, Adami HO, Granath F (October 2003). "Cancer risk following organ transplantation: a nationwide cohort study in Sweden". Br. J. Cancer. 89 (7): 1221–7. doi:10.1038/sj.bjc.6601219. PMC 2394311. PMID 14520450.
  23. Morton M, Coupes B, Roberts SA, Klapper PE, Byers RJ, Vallely PJ, Ryan K, Picton ML (February 2013). "Epidemiology of posttransplantation lymphoproliferative disorder in adult renal transplant recipients". Transplantation. 95 (3): 470–8. doi:10.1097/TP.0b013e318276a237. PMID 23222821.
  24. Penn I (January 1996). "Posttransplantation de novo tumors in liver allograft recipients". Liver Transpl Surg. 2 (1): 52–9. PMID 9346628.
  25. Petrara, Maria Raffaella; Giunco, Silvia; Serraino, Diego; Dolcetti, Riccardo; 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. ISSN 0304-3835.
  26. Petrara, Maria Raffaella; Giunco, Silvia; Serraino, Diego; Dolcetti, Riccardo; 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. ISSN 0304-3835.
  27. LaCasce, A. S. (2006). "Post-Transplant Lymphoproliferative Disorders". The Oncologist. 11 (6): 674–680. doi:10.1634/theoncologist.11-6-674. ISSN 1083-7159.
  28. LaCasce, A. S. (2006). "Post-Transplant Lymphoproliferative Disorders". The Oncologist. 11 (6): 674–680. doi:10.1634/theoncologist.11-6-674. ISSN 1083-7159.
  29. Weissmann, David J.; Ferry, Judith A.; Harris, Nancy L.; Louis, David N.; Delmonico, Francis; Spiro, Ira (1995). "Posttransplantation Lymphoproliferative Disorders in Solid Organ Recipients Are Predominantly Aggressive Tumors of Host Origin". American Journal of Clinical Pathology. 103 (6): 748–755. doi:10.1093/ajcp/103.6.748. ISSN 0002-9173.
  30. Cohen, Jeffrey I. (2000). "Epstein–Barr Virus Infection". New England Journal of Medicine. 343 (7): 481–492. doi:10.1056/NEJM200008173430707. ISSN 0028-4793.
  31. Mañez, Rafael; Breinig, Mary C.; Linden, Peter; Wilson, John; Torre‐Cisneros, Julian; Kusne, Shimon; Dummer, Stephen; Ho, Monto (1997). "Posttransplant Lymphoproliferative Disease in Primary Epstein‐Barr Virus Infection after Liver Transplantation: The Role of Cytomegalovirus Disease". The Journal of Infectious Diseases. 176 (6): 1462–1467. doi:10.1086/514142. ISSN 0022-1899.
  32. Libertiny, G.; Watson, C. J. E.; Gray, D. W. R.; Welsh, K. I.; Morris, P. J. (2001). "Rising incidence of post-transplant lymphoproliferative disease in kidney transplant recipients". British Journal of Surgery. 88 (10): 1330–1334. doi:10.1046/j.0007-1323.2001.01924.x. ISSN 0007-1323.
  33. Caillard, Sophie; Dharnidharka, Vikas; Agodoa, Lawrence; Bohen, Erin; Abbott, Kevin (2005). "Posttransplant Lymphoproliferative Disorders after Renal Transplantation in the United States in Era of Modern Immunosuppression". Transplantation. 80 (9): 1233–1243. doi:10.1097/01.tp.0000179639.98338.39. ISSN 0041-1337.
  34. Minamitani, Takeharu; Ma, Yijie; Zhou, Hufeng; Kida, Hiroshi; Tsai, Chao-Yuan; Obana, Masanori; Okuzaki, Daisuke; Fujio, Yasushi; Kumanogoh, Atsushi; Zhao, Bo; Kikutani, Hitoshi; Kieff, Elliott; Gewurz, Benjamin E.; Yasui, Teruhito (2017). "Mouse model of Epstein–Barr virus LMP1- and LMP2A-driven germinal center B-cell lymphoproliferative disease". Proceedings of the National Academy of Sciences. 114 (18): 4751–4756. doi:10.1073/pnas.1701836114. ISSN 0027-8424.
  35. Leblond, Véronique; Dhedin, Nathalie; Bruneel, Marie-France Mamzer; Choquet, Sylvain; Hermine, Olivier; Porcher, Raphaël; Quoc, Stéphanie Nguyen; Davi, Frédéric; Charlotte, Frédéric; Dorent, Richard; Barrou, Benoit; Vernant, Jean-Paul; Raphael, Martine; Levy, Vincent (2001). "Identification of Prognostic Factors in 61 Patients With Posttransplantation Lymphoproliferative Disorders". Journal of Clinical Oncology. 19 (3): 772–778. doi:10.1200/JCO.2001.19.3.772. ISSN 0732-183X.
  36. Evens AM, David KA, Helenowski I, Nelson B, Kaufman D, Kircher SM, Gimelfarb A, Hattersley E, Mauro LA, Jovanovic B, Chadburn A, Stiff P, Winter JN, Mehta J, Van Besien K, Gregory S, Gordon LI, Shammo JM, Smith SE, Smith SM (February 2010). "Multicenter analysis of 80 solid organ transplantation recipients with post-transplantation lymphoproliferative disease: outcomes and prognostic factors in the modern era". J. Clin. Oncol. 28 (6): 1038–46. doi:10.1200/JCO.2009.25.4961. PMC 2834429. PMID 20085936.
  37. LaCasce, A. S. (2006). "Post-Transplant Lymphoproliferative Disorders". The Oncologist. 11 (6): 674–680. doi:10.1634/theoncologist.11-6-674. ISSN 1083-7159.
  38. Nalesnik MA, Jaffe R, Starzl TE, Demetris AJ, Porter K, Burnham JA, Makowka L, Ho M, Locker J (October 1988). "The pathology of posttransplant lymphoproliferative disorders occurring in the setting of cyclosporine A-prednisone immunosuppression". Am. J. Pathol. 133 (1): 173–92. PMC 1880655. PMID 2845789.
  39. Rappaport DC, Chamberlain DW, Shepherd FA, Hutcheon MA (February 1998). "Lymphoproliferative disorders after lung transplantation: imaging features". Radiology. 206 (2): 519–24. doi:10.1148/radiology.206.2.9457207. PMID 9457207.
  40. Randhawa PS, Yousem SA, Paradis IL, Dauber JA, Griffith BP, Locker J (August 1989). "The clinical spectrum, pathology, and clonal analysis of Epstein-Barr virus-associated lymphoproliferative disorders in heart-lung transplant recipients". Am. J. Clin. Pathol. 92 (2): 177–85. PMID 2547308.
  41. Parker A, Bowles K, Bradley JA, Emery V, Featherstone C, Gupte G, Marcus R, Parameshwar J, Ramsay A, Newstead C (June 2010). "Diagnosis of post-transplant lymphoproliferative disorder in solid organ transplant recipients - BCSH and BTS Guidelines". Br. J. Haematol. 149 (5): 675–92. doi:10.1111/j.1365-2141.2010.08161.x. PMID 20408847.
  42. Parker A, Bowles K, Bradley JA, Emery V, Featherstone C, Gupte G, Marcus R, Parameshwar J, Ramsay A, Newstead C (June 2010). "Management of post-transplant lymphoproliferative disorder in adult solid organ transplant recipients - BCSH and BTS Guidelines". Br. J. Haematol. 149 (5): 693–705. doi:10.1111/j.1365-2141.2010.08160.x. PMID 20408848.
  43. Taylor, Anna L.; Marcus, Robert; Bradley, J. Andrew (2005). "Post-transplant lymphoproliferative disorders (PTLD) after solid organ transplantation". Critical Reviews in Oncology/Hematology. 56 (1): 155–167. doi:10.1016/j.critrevonc.2005.03.015. ISSN 1040-8428.
  44. Wagner HJ, Wessel M, Jabs W, Smets F, Fischer L, Offner G, Bucsky P (September 2001). "Patients at risk for development of posttransplant lymphoproliferative disorder: plasma versus peripheral blood mononuclear cells as material for quantification of Epstein-Barr viral load by using real-time quantitative polymerase chain reaction". Transplantation. 72 (6): 1012–9. PMID 11579293.
  45. Merlino C, Cavallo R, Bergallo M, Giacchino F, Bollero C, Negro Ponzi A, Cavallo G (April 2003). "Epstein Barr viral load monitoring by quantitative PCR in renal transplant patients". New Microbiol. 26 (2): 141–9. PMID 12737195.
  46. Wagner HJ, Wessel M, Jabs W, Smets F, Fischer L, Offner G, Bucsky P (September 2001). "Patients at risk for development of posttransplant lymphoproliferative disorder: plasma versus peripheral blood mononuclear cells as material for quantification of Epstein-Barr viral load by using real-time quantitative polymerase chain reaction". Transplantation. 72 (6): 1012–9. PMID 11579293.
  47. Wagner HJ, Jabs W, Smets F, Wessel M, Fischer L, Offner G, Kirchner H, Bucsky P (2000). "Real-time polymerase chain reaction (RQ-PCR) for the monitoring of Epstein-Barr virus (EBV) load in peripheral blood mononuclear cells". Klin Padiatr. 212 (4): 206–10. doi:10.1055/s-2000-9678. PMID 10994552.
  48. Lemoine A, Pham P, Azoulay D, Saliba F, Emile JF, Saffroy R, Broet P, Bismuth H, Samuel D, Debuire B (September 2001). "Detection of gammopathy by serum protein electrophoresis for predicting and managing therapy of lymphoproliferative disorder in 911 recipients of liver transplants". Blood. 98 (5): 1332–8. PMID 11520779.
  49. Badley AD, Portela DF, Patel R, Kyle RA, Habermann TM, Strickler JG, Ilstrup DM, Wiesner RH, de Groen P, Walker RC, Paya CV (September 1996). "Development of monoclonal gammopathy precedes the development of Epstein-Barr virus-induced posttransplant lymphoproliferative disorder". Liver Transpl Surg. 2 (5): 375–82. PMID 9346679.
  50. Pageaux GP, Bonnardet A, Picot MC, Perrigault PF, Coste V, Navarro F, Fabre JM, Domergue J, Descomps B, Blanc P, Michel H, Larrey D (February 1998). "Prevalence of monoclonal immunoglobulins after liver transplantation: relationship with posttransplant lymphoproliferative disorders". Transplantation. 65 (3): 397–400. PMID 9484759.
  51. Bakker NA, van Imhoff GW, Verschuuren EA, van Son WJ (March 2007). "Presentation and early detection of post-transplant lymphoproliferative disorder after solid organ transplantation". Transpl. Int. 20 (3): 207–18. doi:10.1111/j.1432-2277.2006.00416.x. PMID 17291214.
  52. Camacho, Juan C.; Moreno, Courtney Coursey; Harri, Peter A.; Aguirre, Diego A.; Torres, William E.; Mittal, Pardeep K. (2014). "Posttransplantation Lymphoproliferative Disease: Proposed Imaging Classification". RadioGraphics. 34 (7): 2025–2038. doi:10.1148/rg.347130130. ISSN 0271-5333.
  53. Taylor, Anna L.; Marcus, Robert; Bradley, J. Andrew (2005). "Post-transplant lymphoproliferative disorders (PTLD) after solid organ transplantation". Critical Reviews in Oncology/Hematology. 56 (1): 155–167. doi:10.1016/j.critrevonc.2005.03.015. ISSN 1040-8428.
  54. Vrachliotis, Thomas G.; Vaswani, Kuldeep K.; Davies, Elizabeth A.; Elkhammas, Elmahdi A.; Bennett, William F.; Bova, James G. (2000). "CT Findings in Posttransplantation Lymphoproliferative Disorder of Renal Transplants". American Journal of Roentgenology. 175 (1): 183–188. doi:10.2214/ajr.175.1.1750183. ISSN 0361-803X.
  55. Camacho, Juan C.; Moreno, Courtney Coursey; Harri, Peter A.; Aguirre, Diego A.; Torres, William E.; Mittal, Pardeep K. (2014). "Posttransplantation Lymphoproliferative Disease: Proposed Imaging Classification". RadioGraphics. 34 (7): 2025–2038. doi:10.1148/rg.347130130. ISSN 0271-5333.
  56. Allen U, Hébert D, Moore D, Dror Y, Wasfy S (June 2001). "Epstein-Barr virus-related post-transplant lymphoproliferative disease in solid organ transplant recipients, 1988-97: a Canadian multi-centre experience". Pediatr Transplant. 5 (3): 198–203. PMID 11422823.
  57. BioMed Central. EBV-associated post-transplantation B-cell lymphoproliferative disorder following allogenic stem cell transplantation for acute lymphoblastic leukaemia: tumor regression after reduction of immunosuppression - a case report. https://diagnosticpathology.biomedcentral.com/articles/10.1186/1746-1596-5-21 Accessed on May 23, 2016
  58. Ganschow R, Schulz T, Meyer T, Broering DC, Burdelski M (February 2004). "Low-dose immunosuppression reduces the incidence of post-transplant lymphoproliferative disease in pediatric liver graft recipients". J. Pediatr. Gastroenterol. Nutr. 38 (2): 198–203. PMID 14734884.
  59. Jagadeesh D, Woda BA, Draper J, Evens AM (March 2012). "Post transplant lymphoproliferative disorders: risk, classification, and therapeutic recommendations". Curr Treat Options Oncol. 13 (1): 122–36. doi:10.1007/s11864-011-0177-x. PMID 22241590.