TY - JOUR
T1 - Cellular immunity to Epstein-Barr virus in liver transplant recipients treated with Rituximab for post-transplant lymphoproliferative disease
AU - Savoldo, Barbara
AU - Rooney, Cliona M.
AU - Quiros-Tejeira, Ruben E.
AU - Caldwell, Yvette
AU - Wagner, Hans Joachim
AU - Lee, Timothy
AU - Finegold, Milton J.
AU - Dotti, Gianpietro
AU - Heslop, Helen E.
AU - Goss, John A.
PY - 2005/3
Y1 - 2005/3
N2 - 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.
AB - 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.
KW - EBV
KW - Liver transplant
KW - PTLD
KW - Rituximab
UR - http://www.scopus.com/inward/record.url?scp=20044361817&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=20044361817&partnerID=8YFLogxK
U2 - 10.1111/j.1600-6143.2004.00693.x
DO - 10.1111/j.1600-6143.2004.00693.x
M3 - Article
C2 - 15707412
AN - SCOPUS:20044361817
SN - 1600-6135
VL - 5
SP - 566
EP - 572
JO - American Journal of Transplantation
JF - American Journal of Transplantation
IS - 3
ER -