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Epstein-Barr virus–associated posttransplant lymphoproliferative disorder: Strategies for prevention and cure

✍ Scribed by Andrew J. Nowalk; Michael Green

Publisher
John Wiley and Sons
Year
2010
Tongue
English
Weight
97 KB
Volume
16
Category
Article
ISSN
1527-6465

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✦ Synopsis

KEY POINTS

(1) No therapies for the treatment of Epstein-Barr virus (EBV)-associated posttransplant lymphoproliferative disorder (PTLD) are based on data from randomized clinical trials.

(2) Published clinical experience suggests that implementation of a systematic, stepwise approach to the treatment of EBV-associated PTLD can result in improved outcomes.

(3) Several new second-line therapies, including monoclonal antibody therapies against B cell surface antigens and low-dose chemotherapy for pediatric organ recipients with PTLD, have emerged over the last decade. (4) A variety of potential approaches to the prevention of EBV disease and PTLD, including chemoprophylaxis with antiviral therapy, immunoprophylaxis, and viral load monitoring to inform preemptive strategies, are currently under consideration.

(5) Although many centers have endorsed the use of the antiviral agents acyclovir and ganciclovir for the prevention of EBV/PTLD, there are few data to support this practice. (6) At present, the use of serial monitoring of EBV viral loads as a stimulus for reducing immunosuppression appears to be the most promising strategy for the prevention of EBV disease and PTLD in liver transplant recipients.

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