Cellular immunity to Epstein-Barr virus in liver transplant recipients treated with Rituximab for post-transplant lymphoproliferative disease

Barbara Savoldo, Cliona M. Rooney, Ruben E. Quiros-Tejeira, Yvette Caldwell, Hans Joachim Wagner, Timothy Lee, Milton J. Finegold, Gianpietro Dotti, Helen E. Heslop, John A. Goss

Research output: Contribution to journalArticle

65 Scopus citations

Abstract

The evaluation of long-term cellular immunity to EBV in pediatric orthotopic liver transplant (OLT) recipients after treatment with the humanized anti-CD20 monoclonal antibody (Rituximab) has not yet been explored. At our institution, one child with EBV-related mononucleosis-like syndrome and five children with polymorphic-EBV-PTLD occurring 6-88 months after OLT were treated with Rituximab. Treatment was well tolerated. All children achieved complete remission. After Rituximab, B-lymphocytes were undetectable in the peripheral blood and EBV-load, monitored with real-time PCR, decreased to undetectable levels in all children from >4000 copies/μg DNA at diagnosis. Four to eight months after Rituximab, EBV-load increased (>4000 copies/μg DNA) in four children, and PTLD recurred in three. Their frequency of EBV-specific T-cell precursors, measured by Elispot analysis, remained lower than in healthy controls. Rituximab effectively induced regression of PTLD in OLT recipients. However, EBV-specific T-cell immunocompetence, which may be crucial for the long-term control of EBV-mediated proliferation, did not improve.

Original languageEnglish (US)
Pages (from-to)566-572
Number of pages7
JournalAmerican Journal of Transplantation
Volume5
Issue number3
DOIs
StatePublished - Mar 2005

Keywords

  • EBV
  • Liver transplant
  • PTLD
  • Rituximab

ASJC Scopus subject areas

  • Immunology and Allergy
  • Transplantation
  • Pharmacology (medical)

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