EBV PTLD Abstract Review
~For general information 2016 EBV Virus and Renal specifically the increased risk in EBV seronegative patients with EBV seropositive donors on intensified immunosuppression. Discussion about antivirals such as ganciclovir to prevent reactivation of EBV that are not onco-therapeutic
PTLD is a serious side effect of EBV transplant aquired EBV. Details here. Treatment strategies standard in 2019 include:
~ reduction in immunesuppression (RIS),
~ rituximab, and
~2022 EBV PTLD in SOT, management strategies using preemptive therapy remain standard, the use of preemptive EBV specific CTLs show promising results and safety profiles.update on management and outcomes described here
These results sugggest different causes for early-onset and late-onset PTLD. For early-onset PTLD, young age and EBV seronegativity are primary. For late-onset PTLD, higher risk with older age is consistent with lymphoma patterns in the general population.
~Turns out there are EBV Specific CTL therapies for the prevention of PTLD as of 2002. Funny thing: standard protocols are not effective in generating CTL from seronegative recipients of EBV-carrying organs, who are the patients most at risk for the development of EBV-LPD. Which makes me laugh when I think about the multiple doctors who said “EBV is no problem just a little adjustment in your meds and its only a 1% risk.” They were either arrogant idiots or ignorant idiots. Not sure which. “first, do no harm” or “primum non nocere“
~2020 Trial EBV CTL for rimuxlab refractory EBV-PTLD abstract here. Not sure of implication for EBV+ donor to EBV- recipient implications.